1979, 08-07 Permit: 79-1714 Demo Residence PLAN NUMBER A APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7 c'7 — ' ;7 l
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE "--7— -79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 1, 2 y
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S Frit/...N_--`1.,_-)--4,,ff J 4,3,
7�� 7 r
2. / 5nck, /y► _s Fr�T /7)04:6+ eil r
6WnNER /f i ?HONE
3. {�, W ' GOi'1,5 . )e �`tl. c,v S `-)g2e. J7c1S P1 ? cIF 1 / 1,3
ADDRESS ZIP Required Set Backs in Feet
N . 70 /^ o., n c S w tr. C; 9 QQ(( Jp
North South East West 0 7— C7 — 7 C'
CO RACTOR PHON - Size of Parcel Zone Classification ``_ Li
lJ
rlrN V Type Const. Occupancy Sprinklered
4' ADDRESS ZIP I �
rr*4 - f ti(d4 1=1 yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area Sq.Sq. Ft.
5. ADDRESS ZIP OWL Area Basement Area Garage AreaAr � Storage
Non
CHANGE OF USE FROM TO Split Entry Split Level 1 Rancher/�
�an
6.
No. Baths No. Floors No. Rooms Z. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. �,/ /
7. OF 1C OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK
El BLD. 1=1PLMB. ❑ MECH: ElM.H. CI POOL / _
pe _. of EXEMPTION
DESCRIBE WORK FEES COLLECTED
VALUATION Source GA ELECTRIC WATER SEWER
of
9. Utilities Single $ _
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
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 construction.
DATE r SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. s REQ'D. REC'D. Plan Check
Env.Health
SEPA D
I—
Planning — c_.)
r1
Mobile Home cn
Fire Marshall z
Co. Engineer Other (Specify)
Utilities TOTAL $ � J.!-'1
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist I THIS BECOMES A PERMIT.
DATE OFFICIAL 0 8 — 0 7 9
.—
APPROVED FOR ISSUANCE 7 7 171, —