1979, 09-10 Permit: 79-3698 Plumbing Fixtures 1PLAN NUMBER APPLICATION/PERMITP 7g1-34.I PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT q
`i NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /-1 D
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. •D c 605 strew LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISIO PARCEL NUMBER/S
2.
OWNER PHONE 03 * k48.00
3. * 4800
ADDRESS ZIP Required Set Backs in Feetin
North 'South [East (West * 8,0 0 U
CONTRACTO PHONE Size of Parcel Zone Classification cJ
ADDRESS ZIP Type Const. Occupancy Sprinklered
ei, 5roketu C/y 99 6 ❑Yes ❑No ❑ Req'd. 3 6 9,7 2
fJG6Fl�ft6g n r PHONE Valuation Building Area in Sq. Ft.
F al, ,S3.S-1976 0 9- 1 0-7 9
5'
ADDRESS
P' ^ �� � � ` ZIP
/� DWL Area Basement Area Garage Area Storage 2 6 4 7 9.
91
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE EX NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. 0 POOL
of EXEMPTION
DESCRIBE WORK 1
8.
I X-` ct-e-'S 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 .w .nd ordinances governing this Building
type of work will be complied with whether specified herein or not. The gr. . .f a permit does not presume
to give authority to violate or cancel the provisions of any other state or lo . w regul ' g onst tion or the
______E(.20
performance of co struction. lf Plumbing
DATE 9/7 �� SIGNATURE_ Iif� / Mech.
SPECIAL APPROVALS SPECIAL CO ,DI IONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA U
Planning w
'1_
Mobile Home
Fire Marshall 7
Co. Engineer Other (Specify)
Utilities TOTAL $ y �
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist n �G2/Z THIS B�F7COMES A PETIT. p 0 0 2 _I
DATES 161-79 OFFICIAI y, J 7 — 1 —7 i4 9, 0 * 4 �, U ,J S
APPROVED FOR ISSUANCE