1979, 08-02 Permit: 79-1459 Plumbing Fixtures LAN NUMBER APPLICATION/PERMITPERMIT NUMBER
I. SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7) 7?
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NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
DATE 7/;//
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES p 3 * * 4 Q 5 0
JOB ADDRESS1. f
, -f(a c7 S i tvi.A-c,►✓1a A/ e LEGAL DESCRIPTION - SEE ATTACHED * 4 0 5 0
LOT BLOCK SUBDIVIS ON PARCEL NUMBER/S * 4 0,5 0 6
2.
y
OWNER ON .S E * 0,0 0 8
3. L cL /v e Zt Ate c�/e -Q-v' �j 1 4 5 8 2
ADDRESS ZIP Required Set Backs in Feet +
North 'South East (West 0 8-0 2 7 9
CONTRA TOR P ONE Size of Parcel Zone Classification
4. T.) j• t I/-e-vf?Y 1!5- �� ,T-A.1(_ V Z8--7/4P B 6 4 7 9.
A /p/R//�E5 7�y�p Type Const. Occupancy Sprinklered
! (1J W—7 E_ ICt,AiL Z -.ad r" 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.
No.Baths No. Floors No. Rooms Rec. Room
TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ElKK���a OTHER -
WORK ❑ BLD. yat PLMB. ❑ MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESC WOFK WK
8. 1'�„-iL k (" .y 1 zr
FEES COLLECTED
la
VALUATION Source GAS I 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 •- : _ ume
to give authority to violate or cancel the provisions of any other state or local la • regulating c• struction or the 3/(50
performa :,,..f cQ7lstruction. •
Plumbing
DATE SIGNATUR —...ad : ;m.L'ANL .ice' .ice Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
rn
SEPA
Planning J
_ w
a_
Mobile Home `J)
Fire Marshall ']- _
Co. Engineer O her (Speci y) ) v
E'h'YU14
Utilities
TOTAL $les 0
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS
THIS BECOMES A 7PERMIT. /�
DATE -73 OFFIC L� ``�� E-�-�'`-�. r 8 - U - 1 7 1 5. * 4 O. O lZ I- —
l (( APPRO : FOR ISSUANCE