1979, 08-07 Permit: 79-1687 Plumbing Fixtures 0
}_AN NUMBER APPLICATION/PERMITp
SPOKANE COUNTY — BUILDING CODES DEPARTMENT PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 C
DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS ////yy�W�W//JJ `�6-V , LEGAL DESCRIPTION - SEE ATTACHED
1. LOT OCK /S(JBDIVISION ��� ✓sr /�
PARCEL NUMBER/S
2. 03 * * 3550
OWNER PHONE * 3 5.5 0
3 ADDRESS ZIP Required Set BaclSouth East ks in Feet I * 3 5.5 0 U
North West
CONTRACTOR i i PHONE Size of Parcel Zone Classification A * O 0 0 L,
4• dL O u ZIP Type Const. Occupancy Sprinklered 1 6 8.6 g
ADDRESS
r, / / / 07 2, ,30d, Oyes ❑No ❑ Req'd. 08-07-79
DSR ' PH9NE Valuation Building Area in Sq. Ft.
,. 3-'5.–917 g 6479.
5. ADDRESSZIP DWL Area Basement Area Garage Area Storage
Pry, -max /1/4 ?' ,;/'%/
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. ❑ MVE.
7. OF 0 OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. 1=1 PLMB. ❑ MECH: El M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK 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 o laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. e a ting o_a_ ermit does not presume
to give authority to violate or cancel the provisions of any other stat: or c la regul ti g construction or the /.7 50
Plumbing
performance of construction. ,//
DATE SIGNATURE t I 4i 0We, ^�' Mech.
SPECIAL APPROVALS SPECIA C.NDITIONS:
DEPT. REQ'D. REC'D. _ Plan Check
Env.Health
SEPA o
I—
U
1_1_1
Planning d
Mobile Home
Z
Fire Marshall —
Co. Engineer Other (Specify)
Utilities
TOTAL $ L'' >l
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
r THIS BECOMES A PERMIT.
SEPA Checklist C 0 8 _ 0 7 _ 7 9 16 g 7 c2 * 3 5, 5 0 1,'_
DAT'�� � OFFICI .<.,.. 0
APPROVED FOR ISSUANCE