1979, 11-01 Permit: 79-7102 Plumbing Fixtures'PLAN NUMBER APPLICATION/PERMITP
PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
i' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 3 * * 2 5 5 0
JOB AD2r.651. (/'Z Zs.^ /t). Peese. LEGAL DESCRIPTION - SEE ATTACHED * 2 5 5 0 up
LOT BLOCK SUBDIVISION PARCEL NUMBER/S E * 2 5 5 !01
2 py.NEF}, ` / PHONE * 0' 00 S
3• /ESS !/ Required Set Backs in Feet 7 1 0, 1 2
ADDRESS ZIP 7 r1
North 'South East (West 1 1 -0 1 - 9
I�TR CTOR ONE ` , Size of Parcel Zone Classification
IL.�vI( � war � ten , i 6 6479.
4• A 7 ESS ` •f/�- 2, i ZIP Type Const. Occupancy Sprinklered
�/I,!/ e,_;
Elves ❑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 KNEW ❑ ALT. El AD'N. I=1 RPL. ❑ MVE.
7. OF r` ❑ OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK El BLD. El PLMB. El MECH: ❑ M.H. CI POOL
of EXEMPTION
DESCRIBE WORK , "i�` /p FEES COLLECTED
8. T X /
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 .f laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. he gr nting of a permi' does not presume
to give authority to violate or cancel the provisions of any other stat: o lo :I law regulating tnstructioi or the
Plumbing zz,,so
performan of onsttrruction. /
DATE IIT/ -79
SIGNATURE_ 0� • $ Mech.
SPECIAL APPROVALS SPECIAL CONDIT ONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health r-
SEPA
.=--
Planning — iuZ
Mobile Home
Fire Marshall /
Co. Engineer
Other (Specify) 3�
Utilities So
TOTAL $
Zone Clearance
_ WHEN MACHINE VALIDATED IN THIS SPACE,
V THIS BECOMES A PERMIT.
SEPA Checklist '
DATE OFF' '�
APP WV 0 OR ISSUANCE —