1979, 11-21 Permit: 79-8269 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUIV(BER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT r 77826?
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE ' -q-1-77
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
03 * * 800
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
1. //61�� * 8,GG to
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * G O 62. _
OWNER HONE E is O. 0 L, 8
3. C; a Y1 D e��i n Y ' r 70
ADDRESS ZIP Required Set Backs in Feet 8 2 6 8
. !/6,;2 / :4A North 'SouthEast (West 1 1 —2 1 —7 9
CONTRACTOR "'1 PHONE Size of Parcel Zone Classification
/'p/c,//y'/ 5./41,791,
i � Ci�41 -73/V -2 6479,
4. , •
ADDRESS
/ / L /,,/J ZIP Type Const. Occupancy Sprinklered
/ < � Or _� �/ %/41C`fi V C ?J . Oyes ❑No ❑ Req'd.
DESIGNER 1 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. ,bAD'N. D RPL. ❑ MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. (�PLMB. ❑ MECH: ❑ M.H. D POOL
of EXEMPTION
DESCRIBE WORK
��QQ��'// �� � � " " � �� r� FEES COLLECTED
8 �ATION '1Z +"""•+/t Source GASP �f ELECTRIC FWATAER 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 law regulating construction or the
Plumbing
performance of construction.
DATE// c: /` 77 SIGNATURF;r�`�-' ;im � is5-/�„� ,�3L�v�f Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA CD
Planning c.)
Mobile Home c.c'
Fire Marshall Z
—
Co. EngineerOther (Specify)
Q
Utilities Oci
TOTAL $ ,v
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist I p u
DATE /1-2)-71 OFFICIAI1. +•�J�✓u�ir i L I _., :7 L 6, 7(� I * 3, f}U L {- -
APPROVED FOR ISSUANCE