1979, 09-24 Permit: 79-4624 Plumbing Fixtures [PL'AN NUMBER APPLICATION/PERMIT p PERMIT�UMB ,��
IL SPOKANE COUNTY — BUILDING CODES DEPARTMENT - �s
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE � �7/1�y"1
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOBADDRESS / 0 3 * * 1 5.50
1. /6.7 ' 1.,} // LEGAL DESCRIPTION — SEE ATTACHED
LBLOCK� SUBDIVISION / PARCEL NUMBER/S * 1 5. 5 p n
2 * 15506
OWNER der-Al 7 PHONE
3. I a* E *000 8
ADDRESS 7 i ZIP Required Set Backs in Feet 4 6 2 3 2
North 'South East (West
CONTRACT9AR / PHONE Size of Parcel Zone Classification 0 9-2 4-7 9
4. '`l/ 2:---e / er rt.5es --717114 Cr �'21',CY42 6479,
AD/D/F Er,SS ZIPy '3�y Type Const. Occupancy Sprinklered
( L ISS U 7 - 'Fly G 472-)6 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
❑ NEW XALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF 0 OTHER
WORK ❑ BLD. XPLMB. 0 MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK & yy,- _ /
8. ✓'J Pim/ 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 pre me
to give authority to violate or cancel the provisions of any other state or loc I law egulating const . Ion . 1?,S0
performance .f construction. �, ,Plumbing I
DATE SIGNATURES[[��` 7e, C', Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env.Health
CC
SEPA 8 v
Planning — w
Mobile Home
Fire Marshall ,n, TZ
Co. Engineer Other (Specify) d'�v
Utilities /S.50
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THISBECOMESAPERMIT.
DAT7'2.E1/-7 Oy OFFICI• , 09 _24 -.79 462. 4 z *1550 APPROV 'I FOR ISSUANCE -