1979, 12-26 Permit 79-9437 Renewal Residence to DuplexPLAN NUMBER
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 ADDRESS
• N. 412_ —LH +- UNIUEIzsa—ry RoAD
LOT BLOCK SUBDIVISION
OWNER
3 J( L., SEAL
ADDRESS
11-i-SOLE- M A t--t_oN . Wie-A15A1- E-
CONTRACTOR
4 1 M ics-anst `-t'CRR.A 2 HOS
• ADDRESS
/- Sa4 a. 1\NALyLoN V�RAPAt.fv
5. ADDRESS
DESIGNER
PHONE
ZIP
liZIG
PHONE
9 2 -Z'1'fS
ZIP
`I42/6
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCELNUMBER/S 16,54'3 020i PT. of Sz
of-, TP11(-r 10 y 1 i3 qT p-r- o N N LN e$ of
s z o p 12 lob, VEPA
, ----
Requi
North
ed
Set
Backs
in
Feet
South East
West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. F
ZIP
CHANGE OF USE FROM
6.
TO
Split Entry
TYPE
7. OF
WORK
r❑ NEW El ALT. ❑ AD N.
L;1'13LD. ❑ PLMB. ❑ MECH:
❑ RPL.
0 M.H.
❑ MVE.
❑ POOL
OTHER
No. Baths
Garage Area
Split Level
No. Floors
Storage
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
Rancher
Rec. Room
Rec'd.
Not
Req'd.
DESCRIBE WORK
8 (zEN�WAL —CbbN i1Jprr j2ESjDmcE. 'To b/AP,LI x
VALUATION Source GAS ELECTRIC
of
9. Utilities
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 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/2 (— 7 SIGNATURE
DEPT_
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
P,FN L 6F PSYz-NkR" No,-
& 1--EE 0.61
Z FEe 1PEN£WAL 30
DATE IZ _j. 7`i OFFICIAL -y+'i A
iZi
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
3a
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
7T-3`7
DATE Z17c1
02* *30,50
*30.50 N
94362
12-26-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B CSOME A PERMIT.
12.-2'6 -7'9' 9 4 3:7 z
*30.50 0
a..1—