1979, 11-01 Permit: 79-7088 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT P PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT / ? q7U ��
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE l 30 -77
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
03 * * 3550
JOB ADDRESS . 19 DE
1. fSCRIPTION — SEE ATTACHED
? /– 0 J / * 3550 rn
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 3 2,5 0 U
2. 3
OWNER PHONE * 30 O
B i]
3. C'ADDRESS ZIP Required Set Backs in Feet * G S
North 'South East (West 7 0 8 7 1
CON ACTOR PHONE Size of Parcel Zone Classification
4. i/A#7.f` c��,e91/- Vt cR1 1 -0 1 -7 9
ADD1.R(E"S_S `/''��1/�2�. ZIP tj� Type Const. Occupancy Sprinklered g 6 L 7 9,
l 70 c,?/ a�� j?7.�y� CI Yes ❑No ❑ Req'd. F.
DESIGN 2� ^/, p�pNE 6 Valuation Building Area in Sq. Ft.
5. ADDRESS� f– /– ZIP`�{,J DWL Area I Basement Area Garage Area Storage —
g- /(M'S/,/7/ 9
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE odi. NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. A_PLMB. ❑ MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /f f%� /
8. , I7 //�. 13A�/.res' 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 gran 'ng of a permit does not presume
to give authority to violate or cancel the provisions of any other state or to w regulating cons tion or the 4... ._...a., -
performance
performance of construction. � Plumbing
DATE SIGNATURE -elf/ J % Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
inC
SEPA
Planning U
U..1
Cl..
Mobile Home
Fire Marshall --
Co. Engineer Other (Specify)
Utilities _St
x
TOTAL $ JJ
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
M-3/—'7 , h �-� 1it Q l;1-7,i 7 I ri z 5 -' ,
DATE OFFICIAL . - ., *'./ n i '= .-.
APPROVED FOR ISSUANCE