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1979, 11-08 Permit: 79-7497 Plumbing Fixtures PLAN NUMBER \�� APPLICATION/PERMIT PERMIT��NUMBER SPOKANE COUNTY BUILDING CODES DEPARTMENT �,`F Q NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE �(�U D I q 7g APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES u 3 * * 3 0.5 0 JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 3 0.5 0 J 1. -i r 6e ', 3/ 613 LOT BLOCK SUBDIVISION PARCEL NUMBER/S 7 4 9.6 R 2. OWNER {' PHONE 1 1 —08-79 3. 3�-Zzi. 1,.- ' 1,-46.S' g 6 4 7 9. ADDRESS /� 0:.4',/, •1124' ` ��//,,,,/`// ZIP Required Set Backs in Feet E.-- I,5(.e`7 4 c i4' ' U(•, •112 *"- 'g037 North 'South [East (West CONTRACTOR,, �� aj/ PHONE Size of Parcel Zone Classification Ott-tat,/ 1 .. (7-'1 ,—.V...04- Type 4' ADDRESS �) �Ja ZIP y Type Const. Occupancy Sprinklered -r- �5(/�Jt�j.. 'a4 ti,e, _de � fD37 ❑Yes ❑No D Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area l 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 0 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7. OF E OTHER WORK D BLD. ❑ PLMB. ❑ MECH: D M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK FEES COLLECTED VALUATION Source AS ELECTRIC WATER SEWER of 9. Utilities Single $ r _ 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 3Q, performance of construction. `gip / / Plumbing DATE _ci' SIGNATURE / �l �L' tC6-l./ Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health CC SEPA CD I— Planning — W CL Mobile Home c./) Fire Marshall z Co. Engineer Other (Specify) Utilities TOTAL $ _46r) _ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist / 7 42-(11-4-1-1-- THIS BECOMES ERS A PERMIT. '7 /� Q '7 jn� [ DATE �! • OFFICIAL .I 1 7 9 ! 4 /' / Z *y� U. 5 O Il F APPROVED FOR ISSUANCE -