1979, 08-08 Permit: 79-1754 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT QP PERMIT NUMBER1
SPOKANE COUNTY - BUILDING CODES DEPARTMENT d /---)9- 1.161-
j9 ��jFJ
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE �5 /, �-- �!
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
//N/� * 3Q:�0
* 3050 N
1
JOB ADLfD�_RIESS 3 rol LEGAL DESCRIPTION - SEE ATTACHED * 3 Q 5 0 6
L0fi BLOCK SUB ISION PARCEL NUMBER/S A * 0.00 S (
2.
3. OLWLeAtS 7f PHONE: -
/ --(9M
� 1 7 S 3 f
O �79
ADDRESS ZIP Required Set Backs in Feet 0 8-0 8- 1
2._ ) Z L. ( !A--6u1 Ai North ISouthEast (West $ Q 4 7 9,
CONTRACTQR / P ONE Size of Parcel Zone Classification
"]-1-6 --->v l' rl r S-.2-S -1--NC V�-?i4Z
4. ADDRESSS ZI { Type Const. Occupancy Sprinklered
/1'190
/ 0 7 E _ /7—v t J Lc/6 ❑Yes ❑No ❑ Req'd.
D SIGNER 1. 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 ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK CI BLD. CePLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE W RK FEES COLLECTED
8. P/gun/e AZ % /7 - ti/.
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 laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does no •resume
to give authority to violate or cancel the provisions of any other state or local law regulating cons ctio plumbing -'27 50
performance of construction.
DATE g/ 217 1SIGNATURE \ h.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA
c..)
n
Planning J_�
Mobile Home
Fire Marshall
Co. Engineer Other (Specify) 3 0p
Pe-r,- E
Utilities
TOTAL $ ,SO
Zone Clearance
C WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA ChecklistMn r THIS BECOMES A PERMIT.
DAT
V 9 OFF - AL :`��'. D _ 8..e 7 9 1 7 5, 4 z * 3 0. 7 0 ° I--
APP•OYEE'rOR ISSUANCE 4