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1979, 11-14 Permit: 79-7811 Residence
PLAN NUMBER -"- - APPLICATION/ PERMIT DEPT. REQ -D. REC'D. Plan Check SPOKANE COUNTY - BUILDING CODES DEPARTMENT Env. Health / NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 SEPA APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES Planning JOB ADDRESS L DESCRIPTION - SEE ATTACHED "- LOT BLOCK SUBDIVISION Other (Specify) MBER/S �3 1 _qoi) _ qoC) Z l 2. oZ M OWNE PHONE`'_., Zone Clearance SLI — 5' �reQ�3 FNorthtd-7 ADDRESS ZIP(�� Backs in F etLZ���South 0, East �BWest 'CONTR'F: R DATE OFFICIAL PHONE Zone Classification 4. ADDRESS - Zl,e. Occupancy Sprinklered ❑Yes [-]No ❑ Req'd. DESIGNER PHONE Val,yati �n� ©O `F#DiWL Building7_L in . uU (l 5. ADDRESS ZIP AArea, Basement ArRa Garage Ar Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher s. No B s No. Floors No. Rooms I Rec. Room TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF ❑ OTHER WORK )0BLD. ElPLMB. ElMECH: ❑ M.H. ❑POOL CERTIFICATE of EXEMPTION DESCR E WORK $ o VALUATION -tourite GAS EL TRIC WATER SEWER of 9, utilities 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 p mit does not p sume to give authority to violate or cancel the provisions of any other state or local law re ling constr t" r the performance of construction. DATE SIGNATURE Not R FEES COLLECTED Single $ Building �oM Plumbing Mech. DATE PES2MIT NUMBER 79- 7611 02* *27900 *278.00 *278.00 8 *0.0C! 781.0-9 11=14-79 -9 6479, SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ -D. REC'D. Plan Check z Env. Health / SEPA Planning Mobile Home "- Fire Marshall Other (Specify) Co. Engineer 02 Utilities --�C/ TOTAL $ Zone Clearance /`�� /'/-a'J�v S �'� WHEN MACHINE VALIDATED IN THIS SPACE, THIS.iBIC0O 1 1E,$/� ,rMIT. 4 / SEPA Checklist �r DATE OFFICIAL APPROVED FOR ISSUANCE - A qd. (0 J4 S' fog) q4