1979, 08-07 Permit: 79-1699 AC PLAN NUMBER C PERMIT NUMBER n
APPLICATION/PERMIT /11 ��-�� ����.,
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE lc-
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * * 1 1,0 0
JOB ADDRESS -L, LEGAL DESCRIPTION — SEE ATTACHED * 1 1,0 0
1. � ' t� � C 1 C1k�2 � * 11,006
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. A * 0,00
OWNER PHONE 1 6 9, 8
3. C. Lk__), x���,
ADDRESS _I ZIP Required Set Backs in Feet
c
`J: (�.,ct j, AAC, North 'South East (West 0 8-0 7-7 9
CONTRACTOR [ PHONE Size of Parcel Zone Classification 6 4 7 9,
A.</.._ \;\. L, Q),-11c4C '��,,, 1,,S- -.2..j4-
4' ADDRESS .11 ZIP Type Const. Occupancy Sprinklered
' CI "3e.,q ��,, ,,,..A ek2,G Le Eves ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. 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 Ogt NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK CI BLD.BLD. 0 PLMB. tR MECH: 0 M.H. 0 POOL Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
�1` J (\ I\ FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities X.x k
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
performance of construction. IIp�� �-}}--��.,, Plumbing
DATE SIGNATURE_l��Cf11,�1 LT,C4‘-/-L2-76Mech. )iLO c-,
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA c)
i—
Planning — ,U
0
Mobile Home N
Fire Marshall —
Co. Engineer Other(Specify)
Utilities
TOTAL $ . C
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist l n THIS COziES A rifMIT.
! U Q. Q G * 1, U n
d H
DATE /9OFFIC \rYL
APP': OR ISSUANCE —