1979, 08-29 Permit: 79-3046 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT / PERMIT NUMBER
NUMBER
SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
03 * * 33.00
JOB ADDRESS
1. LEGAL DESCRIPTION - SEE ATTACHED * 3 3,0 0
UB�DI I IN
LOT BLOCK �6 /� bi PARCEL NUMBER/S * 3 3.0 0 Y
2.
OWNER PHONE A *00 0 0
3. 304.52
ADDRESS ZIP Required Set Backs in Feet
North 1South East (west 0 8-2 9-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
F. A I )4 I1 5 -7V'. g 6,479,
4' ADDRESS n / /� ZIP / Type Const. Occupancy Sprinklered
e t+ goy
ry CI Yes ❑No ❑ Req'd.
IllgateltarrR . ( PHONEValuation Building Area in Sq. Ft.
F 17 L- 6:3,6"7- 177g.
5'
ADDRESS o , Vol‹ Ig � ZIP �//yam/ DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO �� Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. CIPLMB. ❑ MECH: CIM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 'x,�u 1-t' /5 FEES COLLECTED
VALUATION Source Jr',/-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 I.ws a • ordinances governing this Building
type of work will be complied with whether specified herein or not. The ging .' : permit does not presume
to give authority to violate or cancel the provisions of any other state or I• aw ;ulatin o truc nor the
performance of construction. Plumbing c�3i
1
DATE SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIAL Cs D TIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
ce
SEPA o
U
Planning w
CL
Mobile Home up
Fire Marshall Z
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist – \ ^ THIS BECOMES A PERMIT.
DATE 7///���f/9OFFICI _ C✓---'- 08 29' - 79 ) 046 * 33, 00o1--
APPR E6 FOR ISSUANCE