1979, 07-27 Permit: 79-1161 AC PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 79' - 116,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE04 COPIES 0 4 * *7.0 0
JOB ADDRESS 1r
1 LEGAL DESCRIPTION — SEE ATTACHED * 7.0 0
se
LO 1 BLOCK SUBDIVISION PARCEL NUMBER/S
2 A * 0.00
3. OWNER wk. �J�L�`e► PHONE C�� S 1 1 6 0 2
AD RES IP Required Set Backs in Feet07 0 7-2 7-7 9
7
North 'South East I West
C TR CTOR P ONE Size of Parcel Zone Classification 2 6 4 7 9.
jty
inti_a
4. A DRESS /� � ZIP Type Const. Occupancy Sprinklered
J1324. t ' ❑Yes ❑No ❑ Req'd.
DESIGNER "-i J'1 1. PHONE Valuation Building Area in Sq. Ft.
5. F/ '
ADDRESS / ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
❑ NEW 0 ALT. 9f AD'N. ❑ RPL. 0 MVE.
7. OF ��E/ry ❑ OTHER
WORK ❑ BLD. 0 PLMB. I MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
� of EXEMPTION
DESCRIB WORK
GAS
. 41)1--
FEES COLLECTED
8. TIO n (1 I ' Source urea : EC I ( Al- i� EWER
of WATER
9, Utilities
TT 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
perfor ...„
ma ce of construction. Plumbing
Af']
DATE LLiL ! �� ��� SIGNATURE' Ill' t y 1
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
rr
SEPA o
Planning w
a_
Mobile Home c.,,
Fire Marshall z
Co. Engineer Other (Specify) pp--����j7,
Utilities l�t+✓
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
,s,SEPA Checklist THIS
COM A E IT.
O` .' ,` Gt.------z- 0 i 1 a *7, 0n a. -J
DAT�/;// 4OFFICIAAPPROV' '
ISSUANCE