1979, 09-25 Permit: 79-4714 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER i
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 7 % J`17/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE g----2-`3--- 7
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 3$* * 3 8.0 0
JOB.ADDRESS /
1 r 419& / i i - C-, LEGAL DESCRIPTION - SEE ATTACHED * 3 a 0 0 N
LU, ow..r. ISION PARCEL NUMBER/S * 3 8,0 0
2.
PHONE E * 0,00
3 4 7 1.3
Ppv)arcc ZIP Required Set Backs in Feet
North 'South East 'West 0 9-2 5-7 9
nTRAFTOR titin PHONE Size of Parcel Zone Classification
�l lee -T wee - _` 2 6[t 7 9,
4. A RESSS ZIP Type Const. Occupancy Sprinklered
V J
/ A. '�1 ,. _ )f ❑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.
No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. D MVE.
7. OF ❑ OTHER
WORK ❑ BLD. aPLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK L---(3
8. / /-1 X-1 , Qe-5 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. Th: granting of a p-rmit does not presume
to give authority to violate or cancel the provisions of any other st•1- or ocal law regulang construction or the iii- 35,00
performanc of con(19
ruction. Plumbing
I /
DATE �G SIGNATURE, I I_I A 4
/ f Mech.
SPECIAL APPROVALS SPECIAL CON'ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
cc:
SEPA
F-
c_.)
Planning ..- w
7_
Mobile Home r'p
Fire Marshall
Co. Engineer Other (Specify)
Utilities/
TOTAL $ —
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL 7 ,_ * 3
APPROVED FOR ISSUANCE