1979, 09-24 Permit: 79-4525 Sprinkler System PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER i
SPOKANE COUNTY — BUILDING CODES DEPARTMENT p 7, 27S.
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 9-21-?9
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD!I'O MAKE 4 COPIES 0 3* * 5. 5 0
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 5 5 0o
1. r 11212 9th
LCST• BLOCK SUBDIVISION PARCEL NUMBER/S * 5.5 0 Y
2. E * 0.00
OWNER PHONE
3 Verne Lange 924-4520 4 5 2 4 2
ADDRESS ZIP Required Set Backs in Feet
North 'South East (west 0 9-2 4-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification L 4 n
Rain-Matic Sprinkler Sys. 926-9508 O 7
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
N. 527 Barker99016 Oyes ❑No ❑ Req'd.
areenarre. , WA
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. 0 MVE.
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8. Sprinkler System
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
togive authorityto violate or cancel the provisions of any other state or local law regulating construction or the 5
Plumbing •�
performance of construction.
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health crz
SEPA
<a
Planning — u_.1
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities 5.�
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 's THIS B COMES A PE MIT.
.. 1111110r0...-
0V - 24._7 .9 52,50 * 5. 50
DATE
2 OFFFIC�" y
APP-o, 1 FOR ISSUANCE -