1979, 08-10 Permit: 79-1988 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT C 4�se,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
03 * * 1 800
JOB ADDRESS ���;�
�% p LEGAL DESCRIPTION - SEE ATTACHED * 1 800 u)
1. � ' %.K /: * 1 8.00.
LOT BLOCK SUBDIVISION PARCEL NUMBER/S Y
2. A
OWNER PHONE A * 00 0 0
ADDRESS ZIP Required Set Backs in Feet 1987 2
E9A /3 y".7.61(,, North 'South East 'West 0 8- 10-79
CONTRACTOR ' PHONE Size of Parcel Zone Classification
4. . 9.c9z4,ac.._ 2 61479
ADDR SS fi ZIP 7 Type Const. Occupancy Sprinklered
3049n5 7 % 7� 037 ❑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. 0 AD'N. ❑ RPL. ❑ MVE.
7. OF _/ ❑ OTHER
WORK ❑ BLD. LMB. ❑ MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. ca j 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 ad
performance of construction. Plumbing
DATE SIGNATURE_ Mech.
4
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health cc
SEPA o
I—
Planning w
0-
Mobile Home
Fire Marshall z
Co. Engineer Other (Specify)
Utilitiesd0
TOTAL $ /0
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist JJ \A110110'''
v '� r. THIS BECOMES A PERMIT.
O8 _W _79
i93, 8 * 1 8. 0
DATE J� OFFIC • 1 -" (2-7 aH
APP•'!VED-FOR ISSUANCE