1979, 09-10 Permit: 79-3642 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 7, -?''4-*2--
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 1200
JOB ADDRESS
1. 4---) 00( \ vi ^CIA ' LEGAL D -SCRIPTION — SEE ATTACHED * 1 2 0 0 i
LOT BLOCK SUBDIVISION 1 PARCEL NUMBER/S 3 6 4, 1 2
2.
OWNER PHONE 0 9- 1 0-7 9
3. 17, -r Q_ 0���r{ � -s3 lif-• 2 6479
ADD ESS GlP Required Set Backs in Feet
IA ' -'�[f H NO N o` X'F.-' North 'SouthEast (West
CONTRACTOR PHONE Size of Parcel Zone Classification
G?AN _02
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑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.
�' No. Baths No. Floors No. Rooms Rec. Room
TYPE IJ NEW ❑ ALT. ❑ AD' . ❑ RPL. ❑ MVE.
], OF �� c
0 OTHER
WORK ❑ BLD. ❑ PLMB. ECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Red. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 V% roR�i-r r�� 041 ,z:7
,(� e
10 , NJ
.= IVO+ ,),---
FEES COLLECTED
VALUATION Source x1/4s\ SxELECTRICWATER 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 local law regulating construction or the
/� yL Plumbing
performance of construction. / �%c-C c_.f' l' '` &,..6.04
`leC4 ( .6"6'
DATE � .a7 y SIGNATURE ,,,Plumbing
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan eck
3-1---3
Env.Health rr
SEPA
Planning _ w
0
Mobile Home
Fire Marshall Z
Co. Engineer Other (Specify)
Utilities
TOTAL $
zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /� \i...=_____Iddirill.c9-
f THIS BECOMES A PERMIT.
DATE� �v /9 OFFICI' 09 - 10 -79 , 64, 2 * 12,001 ~
�!
APPRO i FOR ISSUANCE _