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1979, 11-27 Permit: 79-8407 Mechanical Fixtures
• 19LAN NUMBER APPLICATION/PERMIT //' PERMIT NUMBER A 6 ---/et - sqo SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 04 * * 15,00 JOB ADDRESS 1. © 0-0C:Are--A5/ � LEGAL DESCRIPTION - SEE ATTACHED * 1 5. G 0cri LOT BLOCK SUBDSION PARCEL NUMBER/S * 1 5, 0 02. E OWNERPHONE * O.0 0 E. 3. .w. c +/&we��l 15.1'esrl 840, 0 ADDRESS ZIP Required Set Backs in Feet North 'South East (West 1 1 —2 7-7 9 CO4. ACTOR L.j•o ] L aL L j / PHONE_ �- Size of Parcel Zone Classification aalo IDIt 4' AESS ��91 /� ` Zyp� , Type Const. Occupancy Sprinklered 4, (C2., //•-1/ (1� ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE No. Baths No. Floors No. Rooms Rec. Room EW ❑ ALT. ❑ D'N. ❑ RPL. ❑ MVE. 7. OF // ❑ OTHER WORK ElBLD. CIPLMB. ECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd. of EXEMPTION DESCRIBE WORK FEES COLLECTED 8 (� � '� VALUATIONlyySource TCTR01-1°14 WATER SEWER of 9. Utilities Single $ — 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 Building 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. Plumbing I1IZ� - 1�1 SIGNATURE -I/ 1 ' .12_,, ' �lL ' 15 DATE � ' Mech. 111 SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check / Env.Health d V //6 y, SEPA ;P Planning / — a_ 1 r) Mobile Home `, Fire Marshall _. Co. Engineer Other (Specify) Utilities TOTAL $ f 5°(-) Zone Clearance ` All WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist �( THIS BECOMES A PERMIT. 7 C J DATE �f, '7/OFFICIAL v ' , �� 1 2 7 ' 8u' 0, / z *,1 5.0 0 S� APPROVED FOR ISSUANCE _