1988, 04-27 Permit App: 88000992 MHAPR -27-'38 1E:36 ID:HEALTH SPO TEL NO:509-458-4716
APR -27-'88 13:52 ID:BLOG AND SAFETY-5PD
PROJEC1 NUMDERm 0H000992
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SITE STREET= 192A0 F MARIETTA AVE
ADDRESS.= OTIS ORLHAPD WA 99027
#355 P01
TEL. NO:509-456-4703 #742 P01
PERMIT UNE= RINW.,C, WIDE MOMS HOME
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MURPHY, JrRILyN
19210 E MARIETTA AVE
SPOKANE WA 99027
CONTACT NAME= JERILYN
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DATE
IN/OUT INITIALS
REVIEW COMMENTS
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�;PP-27—'88 15:01
ID:HEALTH SPO
' TEL NO:5O9-456-4715 #365 P01
RPR -27—'88 13:52 ID:BLDG AND SAFETY—SPO
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TEL NO:5OB-456-4703 11742 PO1
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SITE STRL'r,..r.,,, 19210 IL MARIETTA AVL•.
ADDRESS= OTIS ORCHARD WA 990271
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OWNER" MURPHY, JERILYN
STREET" 19210 F MARIETTA AVE::
ADLiki•SS : SPOKANE WA 99027
CONTACT NAME:::. JELE!'LYN
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PARCEL NUMBER:
79
INFORMATION WORKSHEET
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STREET
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STREET ADDRESS:
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CITY/STATE/ZIP: OLI,c O rei ^ nd_ 0 /R 4 9 /6,2y
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BLOCK: (' LOT: `7i ZONE: 9^t4( DISTRICT:
LOT AREA: F/A: WIDTH: 76 DEPTH: / / 7 R/W:
# OF BUILDINGS: # OF DWELLINGS: } WATER DISTRICT:
IN
OWNER: PHONE: 6d99"- c5 9/,2
SUBDIVISION:
MAILING ADDRESS: ,f /C/,ZJ(T I el -La A )&
CITY/STATE/ZIP: O', 1(`�� O r -e, trO tin • 0)
97�2�/
CONTACT:��^I y
lu(� I t I ii -ph/ PHONE: 5-69- /�/-/
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SETBACKS: - FRONT: LEFT: RIGHT:
PERMIT USE:
REAR:
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**********************************************************
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
BUILDING INFORMATION
PHONE:
•
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
REQUIRED PARKING:
X (WIDTH X DEPTH) SQ. FT.:
# HANDICAP: SEWER (Y/N): HYDRANT:
— APR -27-'88 15:02 ID:HEALTH SPOT TEL 110:509-456-4416 #365 P02
. i
PERMIT NO
Name
SPOKANE COUNTY HEALTH DISTRICT
E. 0. PLOEGER, M. D., M,P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201
0 ?APO
DATE J� 82— -A.:2—
No.
No. A 10095
APPLICATION FOR PERMIT TO(/INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
(�
O�1C Address � �%/'• No ! Tad -a�J2r
Address of Proposed Site
Type of Ilse L .v ts-4
Number of Bedrooms
Water Supply
e_/907/O
Is basement for building planned'
29' Building Capacity Camp Capacity
(City. Well• Spring). Orywell
Reis Style of tank
Septic tank capacity
Length of disposal field
/ ,j 0
Other
Absorption Pits Leach Bed
111 'Plow WAIN, location or Proposed house, optic tank,
011001110 tmd, wall, gereae and ether out buildings.
Installe
41/4
I
I t t r
t
,Af 3� I
Ir
Final Inspection Date
Remarks,
4r
a2
CONTRACTOR ` bl
e46 e(V. I,L UH
For Spokane pounty Health District