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1979, 11-21 Permit: 79-8224 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT /� PERMIT NUMBER SPOKANE COUNTY - BUILDING CODES DEPARTMENT r 79-F'Z ' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE f/—`2"/— 79 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES JOB ADDRESS G 3 * * 7, 1 �5ao? r LEGAL DESCRIPTION - SEE ATTACHED * LOT BLOCK S BDIVISION PARCEL NUMBER/S 2. OWNER PHONE E * ('. 3. ADDRESS ZIP Required Set Backs in Feet 8 2 2 3_: North South East West 1 i — 2 1 —,_, ' CONTRAC�R���� � ����� t-vder-o--i- e:b PHONE�/ Size of Parcel Zone Classification 4' ADDRESS 37 / ZIP/� Type Const. Occupancy Sprinklered / '. '� /7 r�-S��v P /-e Oyes No ❑ Req'd- 0 Urt' G p !IVB �� Valuation Building Area in Sq. Ft. ir. 5' ADDRES� [1` �©x /�n� �/ l7ZCI�Pnr�/� DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM GIJf TO Split�(j(�' Split Entry Split Level Rancher 6. No. Baths No. Floors No. Rooms Rec. Room TYPE KNEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE. 7. OF 0 OTHER CERTIFICATE Req'd. Recd. Not Req'd. WORK 0 BLD. 0 PLMB. 0 MECH: ❑ M.H. 0 POOL of EXEMPTION f DESCRIBE WORK 8. �/? rx -se rC 5 ` FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER of r 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 a d ordinances governing this Building type of work will be complied with whether specified herein or not. The gr. ti g . ' a permit does not presume to give authority to violate or cancel the provisions of any other state or kcal eg ' g co str ion or the (.. ...?-43-E performance of constr tion. Plumbing DATE //`� 77 SIGNATURE / Mech. SPECIAL APPROVALS SPECIA CO0DITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health rz SEPA o I— Planning C.) — w a. Mobile Home rn Fire Marshall z Co. Engineer Other (Specify) Utilities /��� TOTAL $�-/�-/ �l Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist i/ THIS BECOMES A PERMIT. -. � �- '7 � , - DATE OFFICIAL G4.2�rw 11.' iv /. .. APPROVED FOR ISSUANCE _