1979, 09-25 Permit: 79-4716 Plumbing Fixtures 0
PLAN NUMBER APPLICATION/PERMITp PERMIT NUMBER i
SPOKANE COUNTY — BUILDING CODES DEPARTMENT � —��
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE q—,z5--7 _
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
03 * *4300
JOB ADDRESS /-
S /Vo2ce / B �4€D5o4) LEGAL DESCRIPTION — SEE ATTACHED *43,00 1-
1. w
LOT BLOCK SUBDIVISION PARCEL NUMBER/S *4 3.O 0 v
2. 0
/
XLcheclfJ ' E 2ff- '<AV *0.0 0
3 ESSr' ZIP Required Set Backs in Feet 4 7 1.5 g
L `�(? X /0 '/ North 'South East 'west 0 9—2 5-7 9
CO TRACTOR V PHONE Size of Parcel Zone Classification
�leE ( 0 vel- . 3.:2_,{;-----3 -''',.)� 2 6.479
4. AESS ) ZIP Type Const. Occupancy Sprinklered
V13ly 4 �7=i',,.-:2/ ❑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 NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. 1131C0LMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /J, FEES COLLECTED
8. f V d,,,..6,A�
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 Jaws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The gra ting of a permi does not presume
to give authority to violate or cancel the provisions of any other state o to law regulati: trfon
g or the / 00
performance f constr. ctioon. Plumbing
DATE 25 [ SIGNATURE_ A.--/- Mech.
SPECIAL APPROVALS SPECIAL CONDIT NS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
Planning v
_ w
0.-
Mobile
Mobile Home
Fire Marshall z
Co. Engineer Other (Specify)
(..L‘,........'
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
0 _ 25 _79 71.01 * 4300,21'
DATE OFFICIAL
APPROVED FOR ISSUANCE _