1979, 12-20 Permit: 79-9350 Plumbing Fixtures PLAN NUMBER - APPLICATION/PERMITPERMIT- .wUER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT q �
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 , DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 3 * * 6 3.0 0
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 6 3.0 0 1,-
LOT
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 6 3 0 0 le
2. B
OWNER PHONE * 0.0 0 0
3 9 3 Ll'9
ADDRESS ZIP Required Set Backs in Feet
North 'South East (west 1 2-2 0-7 9
CONTRARI ��77 PHONE Size of Parcel Zone Classification
VBA, roit,5 I- - j' g 6479.
4' ADDRESS� e i /t.rel-r, 71-71
/7L Dr ZIP Type Const. Occupancy Sprinkle red
``JJ /L ../,L ✓� 141 Oyes ❑No 0 Req'd.
�' PHONE ' T� Valuation Building Area in Sq. Ft.
'
5. (5.a:5.112 _
PO, 'Fox ifai ZIP
ADDRESS 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
TYPEVEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. \PLMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. FX
1., re- FEES COLLECTED
VALUATION Source GAS TZ� 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 n ' g of a permit does not presume -1
to give authority to violate or cancel the provisions of any other state or o )aw r?ulati g co truction or the ,`„. ✓
performance
77of onstruct'on. Plumbing
DATE /Q` //7 e7P SIGNATURE i‘j,L =,, ed Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health (72
SEPA o
I—
Planning — w
0
Mobile Home rn
Fire Marshall z
Co. Engineer Other(Specify)
r�
Utilities TOTAL $ tom
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist //'' THIS BECOMES A�PERMIT. t, (, \_ c
DATE i Rp.(7/"F F I C I A L Gir'I 12 .-2 O _ / 9 3 5 �J * 6 �. 0 �l U
APPROVED FOR ISSUANCE _