1979, 10-10 Permit: 79-5613 ResidencePLAN NUMBER
/2—�
APPLICATION/ PERM IT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ESCRIBE RK
8
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
ke.
LEGAL DESCRIPTION - SEE ATTACHED
LOT
I BLOCII
TUBD IV,ION
PARCEL NUMBER/S 3 J 7 /,-0. 2 07
OW ER
P ONE
3. 10
/J2
DRESS
4
IP
Required Set Backs in Feet / /
/'y
/®
ofNorth
South East V West
CO T` RA
P ONE
Size of2err J
nClassification
ne
4.
ADDRESS
ZIP
Ty pe/Co st.
Occupancy
Sprinklered
'10 01 '
N
❑Yes �Vo 1:1Req'd.
DESIGNER
PHONE
Valuatiorjb
Building Are Sq. Ft.
ru
l
5.
ADDRESS
ZIP
�rea
Base eent ea
Ge Area
Storage
/DVVV
tJ
CHANGE OF USE
FROM
TO
Split Entry
Split Level
Rancher
6.
" "_
— � - /
-
TYPE NEW
❑ALT.
❑ AD'N. ❑ RPL.
ElMVE.
No. the
I No. F oors
No. ooms
Rec. Room
7, OF
❑ OTHER
(�
`P BLD.
❑ PLMB.
❑ MECH: ❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not> 'd.
WORK
of EXEMPTION
,U
� /. IV F -A I Q FEES COLLECTED
VALUATION 00 Sour GAS ELECTRIC 10,!�
WATER �j SEWER
9.�l�, Utilities or A `� E We Single $o
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 7YQ1//
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 ait does not presume
to give authority to violate or cancel the provisions of any other state or oca l law reg, in construction or the
Plumbing
performance of construction.
DATE (fJ0 2y SIGNATURE '
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. IV/ 1 galleyTOSS Plan Check
Env. Health �� W 7
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
`\ c
DATE OFF A
APP ED FOR ISSUANCE
PERMIT NUMBER
DATE
02* *28600
*28600
*28600
E *Q00
561,2
10-10-79
;F 6479•
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS. .B CO $,A P RMIT.
�.-I I- 7, 516`1, 3 z *-2 8 6, 0.0 a
U
W
Z
f
75.6
12 .3
E I I Es
v12%2-�
Nov E
GY2 Cu2�
OPT MINiLCry\C r=IQST
IV��
Ph R �El '�)3 S q I
3c� 7" AVE