1979, 11-01 Permit: 79-7094 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT P •�- 26'87
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /' ''''-',36.--.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
03 * * 3550
JOB ADDRESS
1 e LEGAL DESCRIPTION - SEE ATTACHED * 3 5. 5 0
LOT BLOCK SUBDIVISION PARCEL NUMBER'S * 3 F 5 0
o
2. /
OWNER PHONE B * 0 O 0 0
3. 709, 32
ADDRESS ZIP Required Set Backs in Feet
North 'South East 'West 1 1 —0 1 -7 9
COPCTOR / gij f PHONE Size of Parcel Zone Classification
Vii Kc I �c 4 f`�-1'ia Ys r 90---gier 2 6 L 7 9.
4' ADD ESS CT /�yyy�� di, ZIP /� Type Const. Occupancy Sprinklered
73i-P (57 -vfi 97/`/� Oyes ❑No ❑ Req'd.
DESIGNBR_� n�u��/ J J// PHONE ,�}�� Valuation Building Area in Sq. Ft.
5. 77// rr!!////// - //�{ �/�Vi 6-1C----07/�
ADD SS F ZIP�� � DWL Area I Basement Area Garage Area I Storage
x.30 /moi S:c/e-✓
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE 96 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF [[ ❑ OTHER
WORK CI „..
-
BLD. Ip-PLMB. CIMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. /3- %X Krs 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 goverr'ng this Building
type of work will be complied with whether specified herein or not. The gr. i!'ng of a p• it does n• .resume
to give authority to violate or cancel the provisions of any other state or I• aw reg . onstr on or the .5 .i
performance of construction. Plumbing
DATE SIGNATURE_ , Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA
0
Planning U
— w
Fire Marshall Mobile Home v.)
Z
Co. Engineer Other(Specify)
Utilities Sys
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 9 , THIS BECOMES A PERMIT.
DATE OFFICIAL A .1.1.1// I /L * / �� 5 Ck--
APPROVED FOR ISSUANCE
—