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1979, 07-09 Permit: 79-233 PoolPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 1. 2. 3. 4. 5. JOB ADDRESS 01- ‘/.A/ -- LOT /, Z/2 LOT LOCK SUBDIVISION X3( ,6060m0 �vVN L OWNF�RI Y/ rel 15. ' A ESS/A/ - „r CONTRACTOR / /h/G 01✓6 DESIGNER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S PHONE ZI P PHONE 70,7 Required lSet tBacks in Feet North /© 'South `G Size ofarcel l /`arI IC/ l 1East (West C71 Type Const. Occupancy ne Classi/x. tion tc,S rinklered ❑Yes ❑No ❑ Req'd. PHONE Valuation Building Area in Sq. Ft. 620 ADDRESS ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK 8. 9. LWrvEW ❑ BLD. DE CRIB VAR VUATION Source of Utilities ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH: ❑ RPL. ❑ M.H. ❑. POO L ❑ OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. AL GAS ELECTRIC WATER SEWER 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 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. /;e'u - - DATE — 27 SIGNATURE �0 DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: DATE OFFICIAL APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ +7,00 DATE PERMIT NUMBER 7 T-03-3 *47.00 ©2- *47.00 23.2 07-09-79 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 07-09-79 `030 *47,0u;'H..... rY_ UJ n \j/ N 4