1979, 11-21 Permit: 79-8250 Plumbing Fixtures PLAN NUMBER 1 /6APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 79 8
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
DATE lll(/��/C/ /71
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0 3 * * 1 0,5 0
�� 7 J LEGAL DESCRIPTION — SEE ATTACHED * 1 0„5 0
L T BL K S DIVISION PARCEL NUMBER/S * 1 O,5 0
2.
OWNER p PHONE E * 0 0 0 L
AdtSRESS ZIP Required Set Backs in Feet O 2 4.9 2
y
North 'SouthEast (West 1 1 —2 1 —7 9
CONTRACT P E Size of Parcel Zone Classification
4. 777J--1‘,- iN1 e)V ri r 5 ' - C = VOim'N6,1-, £ 4 7 9,
Ars
_ ZI �yry 7 Type Const. Occupancy Sprinklered
J� C-� C' / s� /SC� f ` �-�� ❑Yes ❑No E Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5.
ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK 0 BLD. AtPLMB. 0 MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ` •/J
8. '/�J 3 ' 9--m 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 govelningthis Building
type of work will be complied with whether specified herein or not. The granting of a permit ..-s not presu e
to give authority to violate or cancel the provisions of any other state or local a regu ing ct'nstru tion or t e = 5e
performance of construction.y •/ .II/ Plumbing
DATE /1 i / 7 SIGNATURE!!V Let V '✓ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. • REQ'D. REC'D. Plan Check
Env.Health '� _f �'–��ly"� L
1 =
SEPA 2
Planning 1 U
— u-i
n_
Fire Marshall
Mobile Home
,� 4��
Co. Engineer Other (Specify) '
Utilities / ' Sc)
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE
SEPA Checklist ` �'/ i THIS1Bt;�C�OI I ,S A �E,iMIT.
DATE OFF CIAL_ 1 11 -- * . _ l ' ,.„'r",
I.
APPRI' F OR ISSUANCE