1979, 10-15 Permit: 79-5982 ResidencePLAN NUMC/�J R
APPLICATION/ PERMIT
- 02 PE-7� NUMBER
2
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SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
0 2 * * 2 5 1.0 0
* 2 5 1, 0 0
2 5 1.0 0
JOB ADDqf-SS
37 4ye— c 1le2c�>
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVI ION
PARCEL NUMBER/S':41 _
I
E * 0. 0 0 000
O ER
T� O)Aj
PHONE
'729-1671
3. C C�
5 9 a 1 2
10-15-79
6,479.
ADDRESS
Z
9D37
Required Set Backs in Feet
N Std 5 -3 L-) w A -'"L+ 2i
CONTRACTOR
f JCC
PHONE
Size of Parc I
S U
Zone Classification
4' ADDRESS
ZIPTyp
e Cq nst.
Occup cy Sprinklered
V l-
❑Yes lVo ❑ Req'd.
DESIGNER
PHONE
Valuation �D.20e>713uiLoing
Area in Sq. Ft.
_
5.`TT
ADDRESS
ZIP
r a
Base rea
Garage Area
�7 Z
Stora e
CHANGE OF USE FROM
TO
S I�i Entry
Split Level
Rancher
6.
TYPE n -NEW ❑ ALT. ❑ AWN. 1:1 RPL. ❑ MVE.
N� the
No. Floors
N .R oms
Rec. Room
'
7, OF
E BLD. ElPLMB. ❑ MECH: ❑ M.H.
❑ OTHER
El POOL POOL
Req'd.
Rec'd.t
eq'd.
WORK
of EXEMPTION
I
8 DESCRIBE v�iWORK �_ FEES COLLECTED
��� ���
VALUAT��
Source
AS
GAS
ELECTRICWATER
SEWER
g, d
Utilities
U17:
�% L
Single $
_
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 ov rning this Building
type of work will be complied with whether specified
herein or not. The gr ntin of a permit d s of pre me
to give authority to violate or cancel the provisions
of any other state or I tion r the
performance of construction.
Plumbing
DATE L
SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
OZ, /
SEPA
Planning
— U
W
Fire Marshall
Mobile Home
GL
Co. Engineer
Other (Specify)
Utilities
TOTAL $ C�
Zone Clearance
�)
%
WHEN MACHINE VALIDATED
THIS7BRCOT� SA�EPMIT.
IN THIS SPACE,
SEPA Checklist
l/ /
Z1, i „ y/-/ /.
7.0 j) i
JC jo * �GJ
/ J. 2.5 1. 0 0
DATE-0FFICIAL� � -2/d 44 / ��
/
i s f
APPROVED FOR ISSUACE
-
ARTISTIC CONSTRUCTION
2216 SO. BOLIVAR
VERADALE, WA 99037 C-1
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