1979, 10-12 Permit: 79-5929 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT p PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 71- 9,.9
NORTH 811 JEFFF RSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE I
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES p 3 * * 3 0 5 0
JOB ADDRESS
1, (/17f` • �l'?Y�,�9f � � LEGAL DESCRIPTION — SEE ATTACHED * 3 O.5 p N
COT ER LOCK SUBDIVISION l PARCEL NUMBER/S * 3 a 5 0
v
2.
OWN R PHONE
3. � C1) � ,S �--Y vf_�' ici ii/ � , tf B * 0, 0 0
AD, RE,SS f 59288
f,S r/ ! J ZJ.13 Required Set Backs in Feet
✓0 � /L X L o� Z,/I PP. C� L c"e6 North 'South East 'West 1 0— 1 2-7 9
C NTRIC T__gg--g� PHONE Size of Parcel Zone Classification
4. .f`� . I---e -v`1 i/(-.)c'-�' .27s 9t"'F—(101 Z 2 61 7 9.
ADDRESS ZAP
'ry /�J Z p(_ Type Const. Occupancy Sprinklered
//6)L' 7 E - / y E�AE J 7C z476 ❑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
NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7, OF ❑ OTHER
WORK El BLD. ig 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 granting of a permit does sume
to give authority to violate or cancel the provisions of any other state or lo al la regulating cons uction r the 1727,5e
performance of/ �construction.
Plumbing
DATE /0 �L ( SIGNATURE C-\ �1 E A-_- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA o
Planning
u1
a-
Fire Marshall Mobile Home ,r
Co. Engineer Other (Specify) 3
pr Lr
Utilities .%a 4 ,�
TOTAL $ (/
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ��)) ��JJ Vf��J,///`/� `�(//j THIS BECOMES A PERMIT.
DATE/0 /`^- 7e1FFICIAL `� ��'��1 �"� '`GZ/�- 47-1 1 Q —1 2 -7-9 5 9.Z 9 z * 3 0, 5 0 a
APPROVED FOR ISSUANCE —