1979, 08-14 Permit: 79-2185 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT c,`,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOBARD TO M1. O3 * * 28.00
,o '
9" � LEGAL DESCRIPTION - SEE ATTACHED * 2S 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 2 8.0 0
2.
OWNER j V�eip S PHONE A * 0.O 0 E3. 2184
ADDRESS ZIP Required Set Backs in Feet
North 'SouthEast 'West 0 8— 1 4-7 9
CONTRACT PHONE Size of Parcel Zone Classification
OW 009c- £cel. IVc.r ...6Z33 5 Y'V 2 6 4 7 9.
4' AD R Sp3 C Z yp� (p�7� Type Const. Occupancy Sprinklered
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. ❑ MVE.
7. OF �/ ❑ OTHER
❑ BLD. LMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
8.
/0 f=IK7,A-c_5 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
i-_:,Planning —
�.
Mobile Home
Fire Marshall —
Co. Engineer Other (Specify)
Utilities Ca
TOTAL $ ��
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 0 i r, THIS B COMES A PERMIT.
DATE ( OFF' • �• -- .._- '` 0 - 14 -79 1. $.5I * 23. iif _
J
APP'IV P. OR ISSUANCE