1979, 10-12 Permit: 79-5910 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT 1.0 PERMIT NUMBER
-1.)-.- 5710
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
03 * * 3800
JOB ADDRESS
1. /42a 1 / /".26'6- 3/' ‘'i1.,t_0l4 LEGAL DESCRIPTION - SEE ATTACHED * 3 °. 0 0
LOT BL SUBDIVISION PARCEL NUMBER/S * 3 8. 0 0 L
2. B
OWNER �/ PHONE * 0 0 0
3. 11- AI el"//,r'rr4- Fhifti, '4if . i2 -fes, 59092
ADDRESS ZIP Required Set Backs in Feet
F /2/0 50 yeti 0p��a// AW7 North !South East (West 1 0- 1 2-7 9
CONTRACTOR //� PHONE Size of Parcel Zone Classification
4. A/1 A 4,/,'6%,'"74C ii – G/i' f ,4aJ.c �f2� -omits/3 b 4 7 9,
ADDRESS / � �/ / / ZIP Type Type Const. Occupancy Sprinklered
3 6/.2 '24'7'1' �i�i•,Co/Glr 99e,7 ❑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 ArNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. 1PLMB. ❑ MECH: ElM.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /�'
8. /9,/' 4.0",•-•4.0",•-•S 7 ' / 7
lC`j 4..., 7L FEES COLLECTED „
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities Single $ s;
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 �3g Cmc,
performance of construction. Plumbing
DATE /e1/4/17‘7. SIGNATURE ���C-"*" �� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
I—
Planning CD
— w
a.
Fire Marshall Mobile Home Cl)
Co. Engineer Other(Specify)
Utilities 3,dd
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
IP 1, � * 0, U � O
) c L
DATE A OFFIC 7.i 1 L 1
APPRO( 0FOR ISSUANCE
_