1979, 11-21 Permit: 79-8244 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 11 79 - 8241-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 71— a/ 79
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES /' 7 I1
JOB ADDRESS (J 4 * * `,0 0
E,19gOer, CO "t LEGAL DESCRIPTION - SEE ATTACHED * 7,0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 7 O O
2.
OWNER PHONE
3. 1,J k I'Jit X35-Fs 1$ . E * 0:C C
-ADDRESS ZIP P�q Required Set Backs in Feet 8 2 4.3 g_
P b. BOX g'..5781U,3 North 'SouthEast West 1 1 2 1 —7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
4. A-I HEAY/AJQ 4 /A i RJCon)3) 41. .958> 12 6479
ADDRESS ZIP Type Const. Occupancy Sprinklered
6 WIEIL,E 99 og ❑
❑Yes No D Req'd.
D SIGNER 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 KNEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF 0 OTHER
WORK ❑ BLD. ❑ PLMB. MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. i a t A L * I .1 d2 1'.4,3 I R N A n➢pLrR 4 V ucr w o R k FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities 54>t 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
performance of construction. Plumbing
DATE SIGNATURE_ Mech.
4
SPECIAL APPROVALS SPECIAL CONDITIONS: '
DEPT. REQ'D. REC'D. Plan Check
Env.Health
rY
SEPA 1r.—
Planning U
— .sJ
a_
Fire Marshall Mobile Home z
Co. Engineer Other (Specify)
Utilities
TOTAL $ 7460
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist //— *Z/— 7.? THIS BECOMES A PERMIT. Li c� # O .i
DATE OFFICIAi 1
11 - 21 7.9 24. 7. 00 2 1--
APPROVED FOR ISSUANCE _