1979, 08-15 Permit 79-2200 MHPLAN NUMBER
I,L�I� IICL�� ► fl��)��'I�I��G;���filLI`u'
SPOKANE COUNTY e BUILDING CODES DEPAIFTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
3.
4.
5' ADDRESS
JOB ADDRESS
B O K
ADRESSfy'(
CO TRACTOR
.47vue_
DDRESS
DESIGNER
6.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
SUtsUI V ISIOIN
CHANGE OF USE FROM
TYPE
7. OF
WORK
8.
9.
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT.
❑ PLMB.
TO
O AD N.
❑ MECH;
❑ RPL.
XM.H.
Source GAS
of
Utilities
ZIP
PHONE
ZIP
❑ MVE.
O POOL
❑ OTHER
ELECTRIC
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S , G <3-4-
t LJ 4 w 6, R R a ,64-K � 3
�3Ac-ous a-ROAvAcR.l~5 /1 D D
Required Set Ba) s in Feet/ !
North .3Q� South 3a"� (East GS IWest /Q
Size of Parcel
Type Const.
Valuation
Occupancy
DWL Area Basement Area
7.20
Split Entry
No. Baths
WATER
Zone Classification
Sprinklered
❑Yes DNo ❑ Req'd.
Building Area In Sq. Ft.
7.2-0
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
SEWER
No. Rooms
Req'd.
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 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 of construction.
DATE ?C—"/%-7�.r^
SIGNATURE
DE PT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
/iql?I � UNI
Co. glneer
.Rfilav,. � 8�14/xJ
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
PIsy Do� Ir��v rt� 0 cN� �
ApPreoAt*fann 1 rq ' Fee a) Co. E 1. ,
e, -Vf
DATE
OFF AL
APP OVfFOR ISSUANCE
Storage
Rancher
ROC. ROOM
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home •
—
Other (Specify)
TOTAL $ /AD�
PERMIT NUMBER
DATE
0 7 * *40,00
*40,00 u~i
21 9.9B
08-15-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISoICOIT E MIT.
/4
EX/s7/Ne
SraRA&c
FX/ST/.v4
SroR/4CcC
Flo
.I
M0.C3/4_6
Home
C/4rfi/...ph AVE
87"
tf ry ¢JP+&r0e_s