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1979, 09-27 Permit: 79-4833 Plumbing Fixtures-' PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7�� _ � I NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 9 —'2 7 — ! i APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS `-' -1 a (°• "—/- LEGAL DESCRIPTION — SEE ATTACHED LOT BLOCK SUBDIVISIO PARCEL NUMBER/S 2. OWNER PHONE 0 3 * * 2 5 5 0 3 iii ADDRESS ZIP Required Set Backs in Feet * 2 0 North 'South East (West * 255 0 6 CONTRACTOR . PHONE Size of Parcel Zone Classification �^ 8 4. /• X54--61 ., (moi`t-j.c it t.t ))2) 7 e%s.� E * O.o o ADDRESS}� J6/14/ /,�// , ZIP f f /�/ Type Const. Occupancy Sprinklered 4 8 3.2 J2 L:.` /©� 4/ ,4 is- 6�. / /r V C, ❑Yes ❑No Cl Req'd. �— PHONE Valuation Building Area in Sq. Ft. 0 9—2 7-7 9 5. ADDRESSZIP DWL Area Basement Area Garage Area Storage R 6,4 7 9. CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE No. Baths No. Floors No. Rooms Rec. Room NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7. OF CI OTHER CERTIFICATE - Req'd. Recd. Not Req'd. WORK CI BLD. CI PLMB. CI MECH: ❑ M.H. CI POOL of EXEMPTION DESCRIBE WORK 8 j x r 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 • la and ordinances governing this Building type of work will be complied with whether specified herein or not. The era n of a permit do s not presume to give authority to violate or cancel the provisions of any other state or loc, la re co ruction or the j performance o con/7 ' . ction. ( Plumbing �(� DATE � e� � SIGNATURE / Mech. SPECIAL APPROVALS SPECIAL ON i ITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health z SEPA O U Planning w 0 Mobile Home Fire Marshall z Co. Engineer Other (Specify) Utilities J, TOTAL $ „Xi :;.> Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist THIS BECOMES A PERMIT. DATE _ _ OFFICIAL 09 27 -79 485. 30 *25. 502 APPROVED FOR ISSUANCE