1979, 10-15 Permit: 79-5958 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT / ,I e PER NUMBER
�0
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 p 3 * * 2 5 Q
JOB ADDRESS1. * 2 5 5 Q cp
ie ycGc 6rA LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 2 5 5 0 cxi
2 OWNER EPHONE * Q 0 0 U
3. L Eli 1.1:/C X 5 Se/s. 59572
ADDRESS ZIP Required Set Backs in Feet
F co ;i>" I rl> 7/..z 0 e North 'SouthEast West 1 0— 1 5-79
CONTRACTOR PHONE Size of Parcel Zone Classification
Svc o /`'�c ,,,6,by s2y-7G os I 6479.
4' ADDRESSJ/ ZI g Type Const. Occupancy Sprinklered
�l S�` `f I� ,/,,7C‘ ❑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.
re
No.Baths No. Floors No. Rooms Rec. Room
TYPE L7 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF �,/ ❑ OTHER
WORK I=1BLD. In PLMB. 1=1MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESC BE WORK „ FEES COLLECTED
8. VALUATION Source GAS ✓ E ECTRIC WATER SEWER
of
9. Utilities
Single $
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 Z6, �0
Plumbing
performance of construction. `
,...)
DATE i�--/5" 7, SIGNATURE .� ., � Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. 7 Plan Check
Env. Health FJ X7L u'(I z
SEPA
UI
Planning — 2
Mobile Home Cl)
Fire Marshall =
Co. Engineer Other(Specify)_
Utilities
TOTAL $ _ _
Zone Clearance
t ` WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist \ - 1 ` THIS BE{C5)MES PEEr7Rryn�IT. r O
DATE 10/6/79"OFFIC 1 U - / 7 5 7 5, 0 5 * 2 5, 5.0 2 i'
APP - OR ISSUANCE