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1979, 10-15 Permit: 79-5990 ResidenceFPLf NUMBER 36e/ 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 JOB ADD 1.75'7 � t 1 17 11 BLOCK SUBDIVISION Mil7li.o1-4L- J� � OWNER 3. t�J-KT !sTi C d ©4) Trzu " J 4' ADDRESS ADDRESS 5 7 •21 30z- 111,4TZ CON1 ACTOR PHONE "i671 LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S 3354/ _q 9c 3 Required Set Backs in Feet North ' ' (Southe�---- East 57 (West /C::;) PHONE Siz-..f Parcel 4-U Zone Classification l � - 4Lt 1StIt 1 ZIP Type Const. Occupancy R-3 �S/9rinklered ❑Yes LNJo 0 Req'd. DESIGNER 5' ADDRESS PHONE ZIP Valuation 2 rea0 Basement Area biz Building Area in Sq. Ft. te6. Garage Area // Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7, OF WORK O NEW O BLD. O ALT. O PLMB. O AD N. 0 RPL. ❑ MVE. O MECH: ❑ M.H. 0 POOL 0 OTHER NoBaths CERTIFICATE of EXEMPTION No. Floors No. Rooms Rec. Room Req'd. Rec'd. Not c_ed. DESCRIBE WORK--y-�— 8. � �) M'/�Z g 7 CT 7 � 7. VALUATION Source of Utilities GAS ELECTRIC 9. 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 gove n g this type of work will be complied with whether specified herein or not. The granting of a permittees nit •resume to give authority to violate or cancel the provisions of any other state or loca la regulatin.. ••./. performance of construction. ,—i���1 DATE ([7 /O— SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities 'one Clearance PA Checklist SPECIAL CONDITIONS: DATE 1• ) � � , D ./ OFFICIAL\-, APPROVED FOR IS MCE FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ DATE / PERMIT NUMBER 02* *29500 *29500 tn- *295.006 E *000 59892 10-15-79 2 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS¶ CO $A RM IT. 0a *295.00 0 - -900 vat_- SEPTtl- TAb4V- NI N \ ---37'r4 •s-ra-a�r zo I 4R"2"'c cftmucriov 216 � SO- BOLIVAR NERADALE' WA 99031 Ll C