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1979, 12-06 Permit: 79-8766 Addition PLAN NUMBL APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY - BUILDING CODES DEPARTMENT -77'• - g 76 :, NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES JOB ADDRESS v G * * 1 0'O O 1. 1D 0°2-- 1411'1LEGAL DESCRIPTION - SEE ATTACHED * loon 2.5401 BLOCK SUBDIVISION PARCEL NUMBER/5 O (0 3 UNiV �`r-( 121-1 �, a © 54�- 39'So 87658 ChANER PHONE 12-p6-79 3. F olcN{Ath+ S OK6a- '",X2- a'71`,� AD.D_RE�S` �� i� ���QG _NortRequih 'South Set Backs'Southee� East I' g 6.4 7 9, IVB `Vl (West ' 1 CONTR(aCTQq. PHONE Size of0PaXelI�° Zone Col�s ica/ti��e r 4' ADDRESS VitwG ZIP Type Const. Occupancy Spi/!i//nklered ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area Basement Area Garage Storage — — 1/ — CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. , ,�,/ No.Baths No. Floors No. Rooms Rec. Room TYPE n NEW ❑ ALT. IQ AD'N. ❑ RPL. ❑ MVE. 7. OF ❑ OTHER - Req'd. Rec'd. Not Req'd. WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE of EXEMPTION DESCRIBE WORK O , FEES COLLECTED 8. Abbi-rbN 19 P<1. 1 '`.- -( ,><'4) VALUATION Source GAS �E( ECTRIC WATER SEWER 9, 500 Single $ �y of y W Utilities ,Er I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included i — on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building 10, 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 performance of construction./> 9 Plumbing DATE/ / SIGNATOR iAilla . ' //<<<✓ Mech. SPECIAL APPROVALS SPECIAL, " CONDITIONS: DEPT. REQ'D. REC'D. Jf 4)fl4. p�t �' F 14 Plan Check Env. Health 'Iy,v11' '` �',_v SEPA o Planning U — w Fire Marshall Mobile Home Z Co. Engineer Other (Specify) Utilities l TOTAL $ Zone Clearance C WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THISBECOMESA PERMIT. DATE4` z57 OF 4611W /�� 1 0 6`-:7 . 7 F,6 * 1 G. U C! 7ri- APPROVED FOR ISSUANCE A /e/r,* /CtJ 1 l l&T /So ,4PpecX f / fzryt3 3 5f Z;Z/ 4 5-0 PPee i\