1979, 11-07 Permit: 79-7418 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT A PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 71^ 7-'7418
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE// —lo '-7/
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 3 * * 3 5 5 0
JOB ADDRES1. ie e.61S ,) LEGAL DESCRIPTION — SEE ATTACHED * 3 5.5 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S B * 3 5 5 0 0
Z OWNER PHONE *0,0 0 U
I,
3 74
Ari Kiivy ,1
ADDRESS ZIP Required Set Backs in Feet
North (South [East 'West 1 1 -0 7-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification 6 4 7 9.
5'4- ® ( i ,N y .91r--,:e/(ie
4. -
ADD ^S ZIP Type Const. Occupancy Sprinklered
/J / £ zi/ 9 2 e 6 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage — •i
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE ral No. Baths No. Floors No. Rooms Rec. Room
00 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. PLMB. ❑ MECH: ❑ M.H. CIPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WOR fl,
FEES COLLECTED
8. /`�vrKI/r 1 ? �, vfv,S,,
VALUATION Source 'I 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 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 lo I law regulating construction or the .2�--�
performancenof construction. �//� Plumbing
DATE /0�. Si3 * /7 SIGNATURE 4+.y�11C./' VCJ'‘'Ill
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT_ - REQ'D. RECD. n
Plan Check
r') /'ri xi
xi,:IFS
Env. Health / cc
SEPA 0
(—
Planning _ w
3-
Mobile Home N
Fire Marshall z
Co. Engineer Other (Specify)
Utilitiesjd
TOTAL $ 3J�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
/f-6'-79 ' /
THIS BECOMES APMIT.
. ,. [Z *'�J.
5 u d -
a.tez� � �G's-- / /€J,qa //`g DATE OFFICIA f.. Q A i 11 O J{. :7 7 q 18
I APPROVED FOR ISSUANCE —