1979, 07-11 Permit: 79-360 Plumbing Fixtures PLAN NUMBER .. APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �Jp
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE IV // `y/
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES /
1 JOB ADDRESS £ / 17a/ 1-71'-61/ LEGAL DESCRIPTION — SEE ATTACHED 0 3 * *38.0 0
LOT BLOCK SUB (VISION PARCEL NUMBER/S * 380 Q v
2. a /ze'` '" B *0.0 0
OWNER PHONE
3. `71/ 7./t--- /C���- 7,Z. /�% 3 5.9 2
ADDRESS p,.i ZIP Required Set Backs in Feet
`//lam ,/ e// %90 4 North (SouthEast West 0 7- 1 1 -7 9
c0 T CTOR PHONE Size of Parcel Zone Classification
K /9,1 7--61a/ 2 6479.
4.
ADIgESS / ZIP Type Const. Occupancy Sprinklered
ADD ESS
?� 2 _e--- 7 7Zn7 ❑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. 0 MVE.
7, OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. X PLMB. MECH: 0 M.H. ❑ POOL CERTIFICATE
-of EXEMPTION
DESCRIBE WORK .-
ORK �s--
8. /: �k.�'-•-C��G / 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 ,?:6L-e
performance of construction. Plumbing
DATE SIGNATURE_ I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health oC
SEPA o
Planning vw
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities G
TOTAL $ e!XJ
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA ChecklistTHIS BECOMES A PERMIT.
DATE OFFIC/L C tiQ 'r v ',�'crvc �J 0 7 — 1 1 - 7 9
t L 7 6.O Z 0 3 p' 0 O
* O
APPROVED FOR ISSUANCE