1979, 12-27 Permit: 79-9547 Mechanical Fixture PLAN NUMBER APPLICATION/PERMIT Ab. PERMITG^liMBER ��
SPOKANE COUNTY — BUILDING CODES DEPARTMENT VV �'�e
• NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE �—* () c _'
APPLICANT: COMPLETE NUMBERED SPACES — RRESS'iE1ARD TO MAKE 4 COPIES
JOB ADDRESS 0 4 * * 1 2 0 0
1.
KI n CA-gip LEGAL DESCRIPTION — SEE ATTACHED
'1 * 1 2,0C
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 1 2.00
OWNER - P},O N E * O.(")0 co
Ci
3. 1t1f,�. 1551014• `r(Z -
ADDRESS ZIP Required Set Backs in Feet 9 5 4.6 2
5°I.AA`-Q-- North 'South East (West 1 2—2 7—7 9
CONTRAC RPHONE Size of Parcel Zone Classification
4. `"1 /Vt dti''r tilde4A-4Q71 2 6,4 7 9,
ADDRESS � � � � D ZIP Type Const. Occupancy Sprinkl
Oyes ❑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. CnL GNM
J No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW IZ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
], OFD❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ISMECH: ID M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK ''
8. l`1S'�rk ( C4 'fie t,GN� , j 4 YL`PV'� 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 not presume
to give authority to violate or cancel the provisions of any other state or Al
alaw regulating construction or the
performance of construction.
Plumbing
DATE 3 ''3' SIGNATURE_ A ).AA '1 /'�
44 .
� (o /
SPECIAL APPROVALS SPECIAL CONDI ILL S:
DEPT. REQ'D. REC'D. Plan Check
Env. Health /0 f0-0 nz B7tJ
_ SEPA
Planning L
/ �� — ❑_
Fire Marshall � � ---/ / Mobile Home _
Co. Engineer Other (Specify)
Utilities
TOTAL $ I�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS fCOME7 A�E,L9MIT. j o *
DAT��.Z7/OFFICIAL____ ff `+ a 'r _
APPROVED FOR ISSUANCE