1979, 08-29 Permit: 79-3042 Plumbing Fixtures h
PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 1 - 3 0+-2—
NORTH
+-`NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. r, ria,2/ 1,2 pLEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION - PARCEL NUMBER/S 0 3 * * 3 3 O 0
2.
OWNER PHONE * 3 3 O O
3. * 3300,
ADDRESS ZIP Required Set Backs in Feet A * O.O O
North 'South East (West
CONTRACTOR �/ , / PHONE Size of Parcel Zone Classification 3 0 4. 1
4. n • a. Nt l/ ,,4- 7923--
ADORES?){c�� RC �//�r� ZIP �// Type Const. Occupancy Sprinklered 0 8-2 9-7 9
r°V1 C�CX ,Col ,9,a2/4 Oyes ❑No ❑ Req'd. 6479,
e ,/ PHONE-z-F, ,' ,7� Valuation Building Area in Sq. Ft.
2 QT/).!)�'
5. JJ L7
ADDR�S�. gD X ,�0� ZIP-? /i/-P DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
Di(NEW D ALT. D AD'N. E RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. D MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK J a
8. / ( i X f1 _re,'5 FEES COLLECTED
r
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities 4
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 I .nti-'! of a permit does not presume
to give authority to violate or cancel the provisions of any other state or o <I a regu ' g nstr tion or the
‘. ( 1)-C)
J?jj�
performance of construction.
Plumbing
DATE SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL •• 'ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA
0
Planning i._
U
W
Fire Marshall Mobile Home vi
Z
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ( THIS BECOMES A PERMIT.
DATE / c•-••."----'J � Q
OFFICIA ( 4Lc5i J `t. * 3 3O U
APPRO
9,F/OR ISSUANCE