1979, 08-14 Permit: 79-2183 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT
PERMIT"NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT -79 19�'
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 03 * * 2800
1. 7L//02 TLS qt-(,� LEGAL DESCRIPTION — SEE ATTACHED * 2&0 0 tot—
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 2 8.O O U
2. I1
OWNER PHONE A * Q 0 0 0
3. Gl tcs lire- .1.940WS c.eraws=-
ADDRESS ZIP Required Set Backs in Feet 2 1 8 2 i
North 'South East (West 0 4
- 1 /� -7 9
CONT CTOR PHONE. Size of Parcel Zone Classification 8
61004 .6.41rA4- itirdie4 ie#14 e— 333 "6-,,W/ 2 6 4 7 9,
4. AOAR SS Type Const. Occupancy Sprinklered
4"1" (01.11.40/k iftx6.
❑Yes ❑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
TYPEEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF R ❑ OTHER
WORK
El BLD. 1Ry�PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. , P 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
performance of construction. Plumbing
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA cD
Planning U
— w
a_
FireMobile Home cn
Marshall
Z
Co. Engineer Other (Specify)
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
o
SEPA Checklist ` THIS BECOMES A PERMIT. l zz pp
DAT
7 OFF •L.. .L .I Q —1 4 —? Z t, J * 2 0. QO..H
APPRS -I FOR ISSUANCE