1979, 07-23 Permit: 79-904 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 19-900X
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS /�
1. 4O/6'- /8 E. :a G LEGAL DESCRIPTION — SEE ATTACHED 0 3 * * 5 3 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 5 3 0 0 rn
2.
OWNER PHONE * 5 3.0 O U
LO 'z2 ' A 0.00 0
3. �` YO a�/kfnDO
ADDRESS( ZIP Required Set Backs in Feet
North 'South East (West 9 Q 3 2
CONTRACTOR P�HH,,O,,,N�F. Size of Parcel Zone Classification
4. �0�0 Sf..A4- /�tc,�1.0JJg44C Sit.. s#ifeV 0 7—2 3—7 9
-
ADDRES c
ZIP / Type Const. Occupancy Sprinklered 6 4 7 9,
lJc Gv 1117.1/V ❑Yes ❑No ❑ Req'd.
DESIGNER 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 4. Ew ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER -
CERTIFICATE
WORK CIBLD. IiMB. ElMECH: ❑ M.H. ❑ POOL Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. 20 riv( 4£3 47)40,014.41 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 laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The grantinI of a permit does not presume 53"V•-•
to give authority to violate or cancel the provisions of any other state or I . lating construction or the „i
performance of construction. Plumbing
DATE 7-A3-77 SIGNATURE . Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
.-•
Planning
- 2_
Mobile Home i-.,-)Fire Marshall =
Co. Engineer Other(Specify)
Utilities
5�I
TOTAL $ 4011
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS,3gCO ))SARE�MIT. iI, 4o
DATEX13-7?0FFIClA14- "1jII /l * `
0 Fi. F"
APPROVED FOR ISSUANCE