1979, 08-23 Permit: 79-2691 Plumbing Fixtures PLAN NUMBER PERMIT NUMBER
[� APPLICATION/PERMIT_
P q 6 y
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
JOB ADDRESS
1. .04 tiS.- D I CC41- LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOC S BDIV SIGN PARCEL NUMBER/S p
2 04 * *2800
OWNER PHONE *2 8 0 0
3 ADDRESS ett` e_ , P 7' 41.5.3
Required Set Backs in Feet *2 O1 Q 0 C,�
f
7 I �'(', .c. / ii�leZ .•v �7n/6 North (South East (West E *Q O O V
CONTRACTOR ,� � �j � PHONE Size of Parcel Zone Classification 2 6 9 0 k
4' ADDQE�SS G//G"vS s,�f,-(/L�j'�J - ��ry�,/ ZIPe?, / Type Const. Occupancy Sprinklered O 'L �7 n
�L�' ael:'' d rV (1.L4.6 4. 9 e 3 ❑Yes ❑No ❑ Req'd. 0 O"2 3— l 9
DESIGNER PHONE Valuation Building Area in Sq. Ft. f 6
4 7 9,
5. ADDRESS ZIP DWL Area 'Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE RrNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF 0 OTHER
WORK
0 BLD. CrPLMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. id 74-' 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 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 v i( Ca
Plumbing
performance of.constr ction. �,f�. ��
DATE J SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
cc
SEPA c)
F—
Planning `CU
a.
Mobile Home co
Fire Marshall
Co. Engineer Other (Specify)
Utilities TOTAL $ q l c/-.
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist c �y 0 � THIS BpECOME7,S A7PE�RMIT. [ (} 1 0
DATED— �7 OFFICIAL .�-a.�,a -C7(Qs '�-' 0 8 —2 3 - l 7 6 7. 1 Z * 2 0. 0 0 0 _-
APPROVED FOR ISSUANCE