1979, 11-01 Permit: 79-7092 Plumbing Fixtures PLAN NUMBER 3. APPLICATION/PERMIT f 79PERMIT NUMBER-- 7a 9
SPOKANE COUNTY — BUILDING CODES DEPARTMENT `
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE A�-30 ~, .
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES * * 3 5 5 G
z y
JOB ADDRESS _
1. �p l Sao20 f� LEGAL DESCRIPTION - SEE ATTACHED * 3 5 5 0 :
L31- BL.:.QCK SUBDIVISION PARCEL NUMBER/S * -3 5 5 (
2. �� B * �' '-
OWNER PHONE O. r
3. 709. 1
ADDRESS ZIP Required Set Backs in Feet
North (SouthEast IWoest 1 1 — 0 1 —7 9
C ACTOR ,41 PHONE Size of Parcel Zone Classification
ArESS 05--- �^fixt ZIP' W6 Type Const. Occupancy Sprinklered
II
[[�ffw {\/ �7j� ❑Yes ❑No ❑ Req'd.
DES( PH E Valuation ]Building Area in Sq. Ft.
5' ADDR SS • ZIP DWL Area Basement Area Garage Area Storage
e, -JC'3Z) 1X155;6A/ C � 7
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPENo. Baths No. Floors No. Rooms Rec. Room
NEW ❑ ALT. El AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK
❑ BLD. r-PLMB. ❑ MECH: ❑ M.H. Cl POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
$ a. Zirec /3 FEES COLLECTED
VALUATIONSource I GAS
of
ELECTRIC WATER SEWER
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 • esume
to give authority to violate or cancel the provisions of any other state or loc. :w regul.. ' g construc 's or the 3�.__._
performance of construction. r Plumbing
DATE SIGNATURE_ f_.,/ A/'/ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
ox
SEPA o
Planning _ w
0_
Mobile Home '"
Fire Marshall z
Co. Engineer Other (Specify)
Utilities -5 —
TOTAL $ iS
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /�--3 M.--3/ 7 q THIS BECOMES A PERMIT.
1�1 � 01 -'79 133, 5 ,
U
DATE OFFICIAL
APPROVED FOR ISSUANCE — f