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1979, 09-13 Permit: 79-3919 Boiler PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I SPOKANE COUNTY — BUILDING CODES DEPARTMENT —1.,---- 37 17 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES JOB ADDRESS • 0 3 * * 1 1.0 0 1. E. g rz, v ,5—'1 - 1/4 LEGAL DESCRIPTION - SEE ATTACHED * 1 1.0 0 16 LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. * 1 1.006 OWNER PHONE A * 0,0 0 8 3. \----10/ A � 0 1 .. `� 4-‘ c ADDRESS t� ZIP Required Set Backs in Feet 3 9 1.8 a eglL9c� is r� ���©6 North 'South East (West 3 CONTRACTOR PHONE Size of Parcel Zone Classification 0 9— 1 —7 9 4. *- A) - 1-),D --E,.>� 1 4.)q- 6-3,/m---V 7 a 6 4 7 9 DS T ' ZIP Type Const. Occupancy Sprinklered L/ I-We �_%��}��j�• ❑Yes 0N ❑ Req'd. • DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area 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 ❑ NEW ❑ ALT. ❑ AD'N. KRPL. ❑ MVE. 7. OF ❑ OTHER WORK ❑ BLD. x.PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. I` of EXEMPTION rWRIBE WORK8. i La e_. '-' _ ... c....gl ( /:?-^ 8—Lc) —...1 a 4 it.) FEES COLLECTED VALUA ON Source GASk............/ 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 granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local I egulating construction or the performance of construction. Plumbing DATE ''//7/ SIGNATURE �� �� Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. Plan Check /— Env.Health / /'S�v ��. 'gCha4e� c �/, fe SEPA C Planning 6u n Fire Marshall Mobile Home 2 Co. Engineer Other(Specify) Utilities TOTAL $ 11 Zone Clearance ` WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist q/ / ! a-�--�-� TF11$dICOI�(IF A PF,{tMIT. 5 9 L 9 z * 1 1. 0 0 a -- DATE v/ 13 / V OFFIC 11 % // APPR V" FOR ;c —