1979, 10-10 Permit: 79-5610 Residencel
PLAN NUMBERI le �" '•"!
—��
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
21 LEGAL DESCRIPTION — SEE ATTACHED
SUBDIV SION PARCEL NUMBER/S
A -e- 1 ] l
A P ONE
,,
'1 ->Jt' L w C qa /� 3
rA
CHANGE OF USE FROM ITO
6.
/s
PHONE
ZIP
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF El OTHER
WORK ❑ BLD. ElPLMB. ❑ MECH: ElM.H. ElPOOL
Required Set Backs in Feet
JOB ADDR/E
1.
/
ne Classification
LOT
BLOCK
Type Cpnst. Occupancy
Sprinklered
SEWER
�<' e
2.
Valua ion
Building Area in Sq. Ft.
^�
OWN
3.
Lt L' C
Gaffe Ar a
SS
2
3-5-10
�
Building
C CTOR
4.
Split Level
Rancher
A DRESS
I No. Floors
1• —/✓ k
Rec. Room
DESIGNER
5.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
ADDRESS
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
21 LEGAL DESCRIPTION — SEE ATTACHED
SUBDIV SION PARCEL NUMBER/S
A -e- 1 ] l
A P ONE
,,
'1 ->Jt' L w C qa /� 3
rA
CHANGE OF USE FROM ITO
6.
/s
PHONE
ZIP
PHONE
ZIP
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF El OTHER
WORK ❑ BLD. ElPLMB. ❑ MECH: ElM.H. ElPOOL
Required Set Backs in Feet
1 /.2
South East West
North71
Size of Parcel
ne Classification
3,5— V l
FAII
Type Cpnst. Occupancy
Sprinklered
SEWER
�<' e
❑Yes o ❑ Req'd.
Valua ion
Building Area in Sq. Ft.
^�
5,6151
DWL Area
Base me t Area
Gaffe Ar a
Storage
2
on reverse side, and know the same to be true and correct. All provisions of laws and ord' nces governing this
Building
'.
Split E ry
Split Level
Rancher
No.cYhs
I No. Floors
No Rooms
Rec. Room
SPECIAL APPROVALS
SPECIAL CONDITIONS:
CERTIFICATE� Req'd.
Rec'd.
Not Re, d.
of EXEMPTION
I
DESCRIB WORK
�
FEES COLLECTED
8 � �
`VALUATION p9
.jj
Source
of
GAS
ELECTRIC
WATER
SEWER
�<' e
Q, �?
Utilities
a^�.
-l-
a vv
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
oa
on reverse side, and know the same to be true and correct. All provisions of laws and ord' nces governing this
Building
type of work will be complied with whether specified herein or not. The granting of a rm does not presume
to give authority to violate or cancel the provisions of any other state or ocal law reg ating construction or the
performance of construction.
/
Plumbing
DATE / �d0 �/ SIGNATUR
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
C
DEPT. REQ'D. RED.
T
v ( '11►p�.G�/"ter • �%
Plan Check
Env. Health /
•
i
SEPA
Planning
-�
—
Mobile Home
Fire Marshall
�/
Other (Specify)
Co. Engineer
Utilities
DATE
PERMI NUMBER
� f _ S ly O
02* *251.00
*251.00
*251.006)
E *0,00 00
560.9-4
10-10-79
;F 6479.
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist l THBOI((,fJ$ASIRMIT.
DATE / U L0 Z * O .Q- OFFICIAK' CAPPROVED FOR Od
,J
40T // &CC,K 2
f� I l)i Lon') E IPIPZ `T A DD i i IC'A1
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