1979, 09-25 Permit: 79-4691 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE _d —352/977
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
4 * * 15.00
1. JOB ADDRESS
�� i LEGAL DESCRIPTION - SEE ATTACHED * 1 5 0 0 i
LOT BLOCK SUBDIVISION J PARCEL NUMBER/S
* 15.00
2.
OWNER PHONE E * O.O 0 O
3 ADDR SS (� ZIP Required Set Backs in Feet
469.0
�.—fie North 'South East (West
09-25-79
CONTRACT R PHONE Size of Parcel Zone Classification
i7,..� ✓ ff. 526-4/e7v 2 6 4 7 9
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
�j/ ,,;;,. ,/,
� e-e 97,20g ❑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 ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER -
WORK ❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE W...0..&„4, --7--
8. "/� /�O/ !JI-04 �' ,A(
/ . / i/a` FEES COLLECTED
VALUATION f Source GAS ELECTRIC �/ WATER f 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
performance of construction. Plumbing
DATE SIGNATURE Mech /� d0
SPECIAL APPROVALS SPECIAL CONDITIONS: 7
DEPT. REQ'D. REC'D. Plan Check
Env.Health / //_ /7`—(f/ /1 / cc
� SEPA C)
Planning / // �49/ —
2- a.
Mobile Home f
Fire Marshall z
Co. Engineer Other (Specify)
Utilities '�7
TOTAL $ /� '—
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist '. THIS COMECS A PERMIT.
7/P'"CV-21%,FFICI
I ,� , C�� —2 ) 7 9 �. i6 9. 1 cl * 15, 0 0 °DATE • . . .. --- —
APPRI r FOR ISSUAN