1979, 09-28 Permit: 79-4941 Plumbing FixturesNUMBER APPLICATION/ PERMIT
PERMIT NUMBER
]PLAN
P ° 9 -sfg�#
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
u J �• * 1 3.00
JOB ADDRESS
5 � �" 4f/,`�%
LEGAL DESCRIPTION —SEE ATTACHED
_5 r/ Aj
* 1 3 0 0
LOT
BLOCK
PARCEL NUMBER/S
2:
ISUBDIVISION
* 1 3.00
E *� ��,
OWUER
_,
%
ON
-51y
a -5 .
too
4 9 4.0t/"/
ADD ESS �
ZIP
Required Set Backs in Feet
"`r
North South East West
09-28-79
ONTR CTO
CONTRACT 0
P�NE
Size of Parcel
Zone Classification
' ' Pyr` -jez
512--s'—tV iV
6,479.
4.
ADDR SSZI
Type Const.
Occupancy
Sprinklered
Yt*
�.2.,l ,
❑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.
TYPE ❑ NEW ALT. 11 AD'N. El RPL. ❑ MVE.T
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF 1:1BLD, XPLMB. E)MECN ElM.H. ElPOOL El OTHER
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESC E WORK FEES COLLECTED
3 J �� � � �
s. G � i4 z- �'� y 7—� U J rc �
VALUATION
Source
GA ELECTRIC
WATER
SEWER
9.
of
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 um
to give authority to violate or cancel the provisions of any other state or local la regulating ns uction or the
performance of construction. ' Plumbing
DATE SIGNATU Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
_
Fire Marshall Mobile Home
/per
Co. Engineer Other (Spec i y)0
i
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist Jf THIS B COME AP7E(R�MIT.
0 � -T9
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