1979, 09-19 Permit: 79-4289 Plumbing Fixtures viBER APPLICATION/PERMIT PERMIT NUMBER
PLAN N� `lam' �
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ID 77 - T�(�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE cI-Iq=Z9
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
1. S. 42.06 3 u4NPEP,LAND h►ziVE_.
LOT BLOCK SUBDIVISION � ( PARCEL NUMBER/S
2. / PO AiD c5 •,4 �C0'; ...__.. 03 * * Q50
OWN
3. w' e� L- - * 5050 tz
ADDR SS ZIP Required Set Backs in Feet
1 —� 1 *
Yr 2 C North !South East (West 5 O. 0
CONTRACTOR / /� 6 PHONE Size of Parcel Zone Classification B * O.0 0 O
4.
---5;4 z, lel 3 i PLA .41€/-4/6 (t X-Y-—IV 2--
/AJDDRESS-7 1—A--A /� ZIP Type Const. Occupancy Sprinklered 428.82
,t `2.— / 4c, L_•.�- .7vv—e 6" Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft. 0 9- 1 9-7 9
6479,
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
IEW ❑ ALT. D AD'N. ❑ RPL. ❑ MVE.
7. OF ,��..��� ❑ OTHER
WORK ❑ BLD. �PLMB. ❑ MECH. D M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. /// Li A 6/ '1/ / FEES COLLECTED
VALUATION Source G' 4�-1 '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 �.D
to give authority to violate or cancel the provisions of any other state or ocal law r ulatin .construction or the
performance of construction.
Plumbing xi
q3'� I Gt 7' SIGNATURE �� 44(..„,_,--
DATE Mech.
SPECIAL APPROVALS SPEQAL CO DITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health cc
SEPA o
Planning U
2
Mobile Home cn
Fire Marshall z
Co. Engineer Other (Specify)
UtilitiesSQ
TOTAL $S"D- ,-
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist q THIS BECOMES A PERMIT. /� Q O
DAT E*—I['7/q OFFICIAL ALi� 0 9 —1. Q —7.9 4 2 8,9 Z k 5 0, 5.@ a ,
APPROVED FOR ISSUANCE