1979, 08-20 Permit: 79-2520 Lawn SprinklerPLAN NUMBER
8/
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
LOT
2.
E. 11823 Lenora Dr
LECfAL DL3CRIPTION — SEE ATTACHED
BLOCK
SUBDIVISION
PARCEL NUMBER/S
3.
4.
OWNER
Jean F. Betts
ADDRESS
same
CONTRACTOR
Evergreen Lawn Sprinkler Co
ADDRESS
E. 5301 Broadway, Spokane, WA
PHONE
X'X928-6818
ZIP
99206
PHONE -
535-4777
ZIP
99211
5.
DESIGNER
PHONE
ADDRESS
ZIP
Required Set Backs in Feet
North 'South East 'West
Size of Parcel - Zone Classification
Type Const. Occupancy Sprinklered
❑Ves
Delo 0 Req'd.
Valuation Building Area In Sq. Ft.
DWL Area I Basement Area ( Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
O NEW
O BLD.
❑ ALT.
j[g PLMB.
❑ AD N.
❑ MECH
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. lawn sprinkler
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
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 _ SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: -
DATE v'ZU/ M OFFICIM
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA'
Mobile Home
Other (Specify)
5.50
TOTAL $ 5.50
P
PERMIT NUMBER
- )_g2°
DATE
03* *550
*550
*5506
E *Q00 8
251.92
08=20=79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 B'ir'2t04; 7 9 2 5 2'0 z * 5.5.0.0
cc
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