1979, 10-10 Permit: 79-5621 Plumbing Fixtures PLAN NUMBER ---/ APPLICATION/PERMIT PERMIT LER I
SPOKANE COUNTY BUILDING CODES DEPARTMENT 79 -
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE l V� 4_/:' I`r.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 03 * * 2800
1. 7yez a Y--4 ) LEGAL DESCRIPTION — SEE ATTACHED * 2 8 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * C
2.
OWNER ( PHONE E * 0 0`i
3. _
ADD ZIP Required Set Backs in Feet 5 6 2 0 1
North 'SouthEast (West 1 0- 1 0—7 9
CONT ACTOR - ` PHONE Size of Parcel Zone Classification
4. Cf 23 6.ti79,
Ai ,)p,REss ZIP Type Const. Occupancy Sprinklered
73?-61`,:5 9"5? Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. —
ADDRESS ZIP DWL Area I 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. p4PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK •
8 pti j �L FEES COLLECTED
VALUATION C.//n rce '[•C�GA'S 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 Oc`.
performance of construction. / Plumbing
g..... .._4,
DATE /'a/A6/a9' SI GNATUREs�ile'UC-GC
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health /
co
SEPA
,,rr c7
Planning V ' —
.'4.0---•-1>
Mobile Home o_
Fire Marshall Z
Co. Engineer # Other (Specify) Roc)
Utilities / p�i 74t
�`• TOTAL $ ZBpQ
Zone Clearance ( C(.) '1 01
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. * p
0 1
—,-
0 -79 6 , 1 _ 2 8
42,o�� �i f'� f s.4l''Ll — i' DATE OFFICIAL 1
APPROVED FOR ISSUANCE —