1979, 10-29 Permit: 79-6952 Remodel PLAN NUMBER APPLICATION/PERMIT 0 PERMIT NUMBER*' I
SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /0-2.9— f./
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS O * * 1 0 O 0
-C_. LEGAL DESCRIPTION — SEE ATTACHED * 1 0.0 0 to-
LOT BLOCK SUBDIVISION PARCEL NUMBER/S �: —arm l 6 9 `a 1
2. / / ' e4i .i? :. .4-1,c, .=2.,pd 7
WNER PHONE LOT/0 BLK /g 1 0-2 9-7 9
(
3. .i-e- 7t..,P .4-- ^ _ .2-.2-/917 E,4/ /,y DA ci)N -:2 AID APP
ADDRESSp:- C// ZIP Required Set Backs in Feet 2 6 4 7 9,
( '' ./41/.2
/ /92---4 --:i- 9,,-) 7 North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
4' DRESS, ZIP Type Const. Occupancy Sprinklered
``1,44 — ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area, Garage Area 9 Storage
CHANGE OF USE FROM TO Split Entr 1 Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. /
/
7. OF ❑ OTHER
WORK CIBLD. ❑ PLMB. IDMECH: ElM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK �`i ' -�
8. /`l%,�-L'ZeD-i-' ,-7Lf/r 2-(L�d LX_ / 71)-a.41,61,-, >071 FEES COLLECTED
ALtt�JATIONi� Source GAS ELECTRIC WATER SEWER
y of
g.'" . ..-.6/ 9 Utilities Single $ —
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
.00
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
1 Plumbing
performance of construction. C,.(1), nea.....-(
L E ��— SJ `7 y SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. 9/i / ._ kL- Plan Check
Env.Health `'7�
—
SEPA
Planning '/1/ P '',f/�/1yr,(//�////pomp, CD
W
W
Fire Marshall Mobile Home
Z
Co. Engineer Other (Specify)
Utilities
TOTAL $ /D
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ei THIS BECOMES A PERMIT.
��� 9-7/ { 1 9 ''7 9 0 95, 2
DATE OFFICIAL„' v m_ -, +�� -, `
APPROVED FOR ISSUANCE —