1979, 09-17 Permit: 79-4085 Addition PLAN NUMBER APPLICATION/PERMITPERMIT NUlviirE'R
SPOKANE COUNTY — BUILDING CODES DEPARTMENT VVV7171 -x}110 85
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE `l�y—I 1-1,--7 /
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 32.00
JOB ADDRESS
1. Iy MC) E 1 aTh LEGAL DESCRIPTION - SEE ATTACHED * 3 2.0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S W. /4.2 'd-' ` �7--•-.�(- 7 * 3 2 0 0 c_
2 OWNER PHONE _ E * 0, 0C
3. v c) .,it t 4 is CIO ��`y 3 �(1�:,� 408, 4 -2
ADDRESS ZIP Required Set Backs in Fe t
1`-I c t� £ I a fh y/ .� . North ISouth l€',�t(}ICS �~x`s(Wests 0 9- 1 7-7 9
CONTRACTO/�.. i PHONE Size of Parcel Zone Classificati n
4' ADDRESS
.. ZIP ` Type Const. Occupancy Sprinklered
(5 l ai i uocu-it (i d,.L,, /�/ ./'' Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
i
c-.,j I rn +10(; :j elt —(,--i,,--: �ehI L -L /%.
5' ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
-__.S la. / Loot d1 !9- ,6 .. .I
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. _ ----- _____, ______
TYPENo. Baths No. Floors No. Rooms Rec. Room
❑ NEW D ALT. AD'N. ❑ RPL. 0 MVE. `
7, OF ❑ OTHER -
WORK
0 &D. 0 PLMB. ❑ MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION A.
DESCRIBE WORK (�
8. bCklicrol d �� `�� t, ` 4 f FEES COLLECTED
VALUA ION Source GAS ELECTR WATER SEWER
t
9, 6.00 Utilities Single $
—
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included X'r eZ
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 constru tion or the
performance of construction. ni '
Plumbing
DATE q- 7` 1 Ci SIGNATURES ./11 alagiai VVI,- , i Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
:71G/—Xe't� /j' ?/��/ SEPA — o
Planning
W
Fire Marshall Mobile Home
Z
Co. Engineer Other(Specify)
Utilities
TOTAL $ .1 r; �
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /� p �f^ t THIS BECOMES A PERMIT. 7� !�
DATE ?—? 71 OFFICIAL L F /Z/Sr Py� 09r-,17.- 79 -', ii 8. ? Z * 3 2. U (3 C- !-
APPROVED FOR ISSUANCE J _