1979, 08-27 Permit: 79-2933 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
2 i3y SPOKANE COUNTY — BUILDING CODES DEPARTMENT C=� 79� Zq 3,3
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE Aub 11 71
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES C 2 * * 5 4 0 0
1 JOB ADDRESS
/ / T . LEGAL DESCRIPTION - SEE ATTACHED * 5 U 0 0
. E / c
)
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 5 4 Q 0 6
2. c--- (1 je_/c:/ci 14 D /) B
O ER PHONE C.- -/ — Ci 0/L- PC�K 1 1 c IJ O F *0 Q 0 S
3. , 6 . Lk-A-C 4_ (c e.',7-17 cog.- -7---/a_ 2 9 3,2 k
ADDRESSZIP RerrITIMI Set Backs in Feet
�N /, /—/ c _us( `) --"(,)GK-1,1_-_,7
990.--7) Y�
North ISouthS / East (West-Z1� 08-27=79
C TRA TOR PHONE Size f Parcel Zone Classification
IV\ a —�VI-LaXIL/ 01/G - 2 6 11 7 9
4' ADDRESS ZIP Type Const. Occ pancX Ma'Sprinklered
N - ) EYes No ❑ Req'd.
DESIGNER PHONE Valuati n Building Area in Sq. t.
�� p6 U" /&/7 -t— -8 1.)
5. ADDRESS ZIP DWL Area f Bsemen-Are Garage Area Storage —
/0/ 7 To 7U-No
CHANGE OF USE FROM TO Split Entry Split evel Rancher
6. //"
TYPE �-,( No. Baths No. Floors NO.,?()MS ms Rec. Room
ldJ N W ❑ ALT. ❑ AD'N. 0 RPL. LIMVE.
/ /
7. OF / \ ❑ OTHER -
WORK BLD. ❑ PLMB. 0 MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION �j/`,
DESCRIBE WORK i
{. ^ FEES COLLECTED
8. 'z 1-E`er „ /J9 -�� d a.,y'I✓L _�--
VALUATION _ Source 1 GAS ELECTRIC WATERlSEWER
9. Utilities PlOci L lam- R, l fiC.-( 1 1 c' Single $
I hereby certify that I have read and examined this application and have read the "NOTICE” provisions included 00
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
Plumbing
performance of const uction.
DATE P /f 7 SIGNATURE Q‘. I Lc?)-b-r, _Q
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
01/i
.r
Planning _ U
w
FireMobile Home vim)
Marshall
Z
Co. Engineer Other (Specify)
Utilities
TOTAL $ 5-iitV
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ,- , / ,I THIS BECOMES A PERMIT.
DATE r OFFICIAL-- < . C i / it t iL - 0 8 —2 l 7 9 9 5, 5 Z * 5 `, 0 0 L
APPROVED FOR ISSUANCE
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