1979, 09-10 Permit: 79-3626 Change Roof Line (PLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
--`,c, / SPOKANE COUNTY — BUILDING CODES DEPARTMENT 71_ 06 ‘, 6
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /vUC 3),/4'71
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES Z
JOB ADDRESS 0 2 * * 43.0 0
LEGAL DESCRIPTION — SEEATTACHED
it A_5-- T „4 * 43.00
LOT BLOCK SUBDIVISION PARCEL NUMBER/S6"� 3-e)4, v
2. A,DT 01-1: 6' * 43.006
OWNER PHONE
�t't4j c�ik - 3367-.2:41,6 VALE- .Y V'E v I//A 4.5 -A ADD A *0 0 0
3. aP
DRESS ZIP �^ Required Set Backs in Feet 3625 g
F..!, 6 3/9 7 _ rig a/J)- 4 � 4.,-, � o--.e Ccs North 'South East 'West r� r1
gNT CTO PHONE Size of Parcel Zone Classification 0 9— 1 0-7 9
. V(2.--1-44,�- 9-29- _? l `rD+ /2/ I A6 alclA-zuK&-4't4B 6479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
��tif� `
6-.�/+J` At /fV�� � .Lnl.(1" �4i2-04.444 .— �����` �^N )2—'3 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Ar ni5ij Ft�s e
5. 4144414A, — E. ,l -d ,,(`'(✓c t..�'i
ADDRESS ZIP DWL AreaBasement Area Gar ge Area d storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
❑ NEW MALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: 1=1M-H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
_,DE�SC� RIBE,VOR��`l FEES COLLECTED
8.�'-l�f,/i: !t -1 '( L-I Ie i— 5/./;-1 -, A? les---24-_,&44-itte-eltte2ei-X1
VALUATION Source G S ELECT
C WATER SEWER
of
9, gdZ)t)-� 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 � `r
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. / Plumbing
DATE �.-�e - 7 47 SIGNATURE *iRA., r f✓�"l L`� .�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: r� d
DEPT. REQ'D. RECD. �1,7(44��l�l.f{t4co`-. Plan Check
Env. Health 8 ,
CC
' ,D CU �Ul/K-�9 p-0 , z -ii-- 1A.2 tect� SEPAI—
V••••
Planning �;"
•••• w
C1-
�✓ 'WVMobile Home z
Fire Marshall i
Co. Engineer Other (Specify)
Utilities 4 a
TOTAL $ /,C
Zone Clearance •
MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist J A" THIS BECOMES A PERMIT.9
DATE /J OFFICIAL =` '( ',L ' - JWHEN
'� 9 10 _7 " 36262 *'43, 00a1-
• APPROVED FOR ISSII'A CE
—