1979, 08-29 Permit: 79-3044 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
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 0 3 * * 3 3 0 0
JOB ADDRESS
1.
/ a? 1/a, LEGAL DESCRIPTION - SEE ATTACHED * 3 3 0 0 n
LOT BLOCK SUBLIVI ION PARCEL NUMBER/S n * 3 3.0 0
2.
A
OWNER PHONE * 0 0 0 o
3. 304.38
ADDRESS ZIP Required Set Backs in Feet
North 'SouthEast 'West 0 8—2 9—7 9
CONTRACTOR PHONE Size of Parcel Zone Classification 2 Q et 7 9
4. ADDRES ZIPy7 1Type Const. Occupancy Sprinklered
KC. gek /1/0,;2fy1 �/4�3 I ❑Yes ❑No ❑ Req'd.
1C70 „ g3- w Valuation Building Area in Sq. Ft.
5.
ADDRESS ?• /'
� ,`� � ZIP � DWL Area I Basement Area Garage Area Storage
` &. ge� /�C/ .95g/
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
(ANEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK
8. //"_"// /�_�
X GC- L'(S 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 • an '-g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or .'al regu cons uction or the
performance of construction. Plumbing
DATE SIGNATURE_ - J—' Mech.
SPECIAL APPROVALS SPECIAL Co N 6 ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
r
SEPA J
Planning w
2
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /O/ THIS� CO APE MIT. /� /� o
DATE"(A9 1 j O F F I C I A ' <'�Er `-`-'"-(� — l 0 `t Y z * 3 3, 0 ° f
111 APPRO,4 i FOR ISSUANCE