1979, 08-10 Permit: 79-2013 Plumbing Fixtures APPLICATION/PERMIT PERMIT NUMBER
ALAN NUMBER / 9 - �0
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
J ADDRES 0 3 * * 2 5.5 0
1 /0 ��e_ "\'( I LEGAL DESCRIPTION - SEE ATTACHED * 2 5 5 0 ,
T BACK SU�p�VISION \ PARCEL NUMBER/S
2. O)` l�Q_V\ C \C` S0\1\ * 2550
OWNER o PHONE E * 0 0 0 8
3. ____\..N.,..\\ �� �( GAS
AD S (/�� \"1 (((I����(^ .�� ZIP Required Set Backs in Feet 2 0 1.2 2
' �, i- t `y' \ -t— North (SouthEast (West
CONTR OR NE Size of Parcel Zone Classification 0 8- 1 0-7 9
11 ,'�r S� V �1 v ��. / � 2 6479.
4. f�p�RES> � \YV1 �� 1
Type Const. Occupancy Sprinklered
I� \ Q ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF " ❑ OTHER
WORK ❑ BLD. "PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DES^ IBE WORK i FEES COLLECTED
8. 4?_w U,Am v a1 - l X.\-- kr-4?-5
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 not presume 5G
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the 2,5
perfor ance of construction. , " Plumbing
DATE— 1 0 —� I SIGNATURE �1�\Q\anMech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env.Health
SEPA 0
I—
C_.,
Planning — w
IL
Mobile Home Cl)
Fire Marshall _
Co. Engineer Other (Specify)
'Itilities
TOTAL $
,ne Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
EPA Checklist 7 THIS BECOMES A PERMIT.
U U — I O — 7 9
1. 1. J * C.
r L J
DATE( /Y OFF( •L7 sr c,—. _
APP•O OR ISSUANCE _