1979, 11-06 Permit: 79-7352 Plumbing Fixtures KLAN NUMBER APPLICATION/PERMIT p PERMIT NUMBER I
L SPOKANE COUNTY — BUILDING CODES DEPARTMENT --ict 357
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE l/` _-__/,,,--;/-
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 3* * v 3, t, 0
JOB ADDRESS "'1
1. . /_'_ OC APr 7 Y .`;=- LEGAL DESCRIPTION — SEE ATTACHED * 3 3, 0 c rti
L BLOCK UBDIV SION PARCEL NUMBER/S 7 3 5, 1 2
2.
OWNA1 ii PHONE 1 1 -0 b-7 9
3. A7- 1 !, C S Y Ke 1 l� '',72- -
`�242 6 4 7 9.
ADDS5 // l / ZIC ` ew Jj Required Set Backs in Feet
0'-P C %, /0 1 j) 12, j i Jam! - 6 North 'South East IWoest
CO NTRACLO P ON Size of Parcel Zone Classification
4. �J E Fed' ) L .. �-rkic_ jE. ''=1�iz
ADDR /$S// �} ET-
+I Z`##�L.r� ,f Type Const. Occupancy Sprinklered
„d LQ✓, 7 L=- 74 e AI ./ L l 2-e) J' ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. -
ADDRESS ZIP DWL Area I Basement Area Garage Area r Storage
CHANGE OF USE FROM TO Split Entry Split Level I Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK ❑ BLD. PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 FEES COLLECTED
VALUATION Source GAS ELECTRIC 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 grantin• • a •• :• •• resume
to give authority to violate or cancel the provisions of any other state or 1• .I : •• ructio •r the '''V', /
performance of construction. A11111PrPlumbing
DATE //— 2 < / SIGNATURL_ - %% a - Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
x
SEPA o
Planning — w
Mobile Home rn
Fire Marshall =
Co. EngineerOt r (Specify) J iJ
" ' it-
`litiesz -JjJ
TOTAL $5,:.--1
_ . (
Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL
11 —O6 -7 755, 26 *33. O0 � �
APPROVED FOR ISSUANCE -