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1979, 11-16 Permit 79-8017 Game Room
PLAN NUMBER g- /31 „ P L,[I©Ea F]©LII/P IAh I[I 13 SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / .,r'OKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS 1.1 ////7 LOT BLOCK 2. /a. OW ER PHONE seAdi(Lehe ADDRESS ZIP 99206 "SU,BDIVISION e . /I6 / 7 (1a ed 6-ke 0 COfJTRACTOR 4Cly /L�- 4' AD'RE S PHONE ZIP 5. DESIGNER PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S 0 c/. 4 1 1_DT/Z /3tiK 1=1E/RACRk. MD1.3/-(HdMs 51113. ADDRESS ZI P Required Set Backs In Feet / North 79, (South /0 Size of Parcel 71 ' x ) 40' i ppp ..ox Type Const. Occupancy V-N 3 VA,Iuation �r 3000 o0 DWL Area o2. Opa East /a p / West 1/ Zo e Classificati n ICQ_ Sprinklered ❑Yes ❑No ❑ Req'd. Building Area jn Sq. Ft. IBasement Area Garage Area Storage 6. 7. CHANGE OF USE FROM TYPE OF WORK El NEW L7 BLD. ❑ ALT. ❑ PLMB. TO AO'N. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER Split Entr Split L vel / 406/1it No. Baths No. Floors / No. Rooms Rancher Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. x DES RIBS WORK 8. VALUATION 4(�-�u%12. ,o-kup 2J . 9. ,,00d ao Source of Utilities GAS ELECTRIC WATER SEWER 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 permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance ofr construction. DATE // /J 7 9 SIGNATURE an.2 1W4te-LG c74--✓ DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health //// Planning Le2.,e Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: PLANS lK DATE )I-1 i- 71 OFFICIAL <4.1Yn. 041 APPROVED FOR ISSUANCE FEES COLLECTED Single $ 7/fe'Ll- Building Plumbing Mech. Plan Check - SEPA Mobile Home Other (Specify) TOTAL _ 7y-1) �J NUM -1�ER — gd/77 PERM IT DATE //—/6, - 7Y 02* *74.00 *74.00 1 *74,006 *000 8'01,6g 1-1 i.1 6-79 g 6479, VI-IEN MACHINE VALIDATED IN THIS SPACE, HIS BECOMES,A PERMIT. 1'1-'16='7,9 801,7z *.74'00. 1 131.aa L4e+ 121 1rc,t1- 09159 -Jibt2.1 A:1411/44,es' . I ;