1979, 12-20 Permit: 79-9358 Plumbing Fixtures PLAN NUMBER1
APPLICATION/PERMIT PERMIT NUMBER -�c�
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 4:vp16) `�� '
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 03 * * b 3.0 0
JOB ADDRESS
1. //�/ 9l6 // - Are. , LEGAL DESCRIPTION — SEE ATTACHED * 63.00
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 63,006
2. B * 0,00
OWNER PHONE c
3. ZIP Required Set Backs in Feet 9 3 5�7
ADDRESS
North 'South East West 12-20-79
CONTRACT PHONE Size of Parcel Zone Classification
5479,
-i k , c!p4... V a9-y
ZIP Type Const. Occupancy Sprinklered
4' ADDRESS/ 7/ , 7 I Or, ���6
�06r7`C� �i �rrt'� -IL Oyes ❑No ❑ Req'd.
PHONE Valuation Building Area in Sq. Ft.
E. 131 4.1(56'-'7S24 —
5'
ADD sA _ ZIP DWL Area Basement Area Garage Area Storage
ff(C����ll 6 x Ilto /1 77,x/,
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 111BLD. X PLMB. CIMECH: CIM.H. ❑ POOL
of EXEMPTION
i A
DESCRIBE WORK /' FEES COLLECTED
8. `7 `F X�l� �tv '
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 sting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or cal/la regulatin construction or the Plumbing wt
performance of constr ction. 1./// i /
l J GNATURE 1,q ""�/����'
DATE / / ���� SI ' Mech.
SPECIAL APPROVALS • SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA `,
u)
Planning n..
Mobile Home `n
Fire Marshall
Co.Engineer Other (Specify)
Utilities or
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist 7 -fit �; f o * / Z (' Il a'
Q
DATE [ OFFICIAL 1leilli4 �i��.I/L.. �._ — 2 u}'-7 / i 5 J.�1 J.UU d i--
APPROVED
-APPROVED FOR ISSUANCE —
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