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1979, 12-03 Permit: 79-8584 Plumbing FixturesAPPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DESCRIBE WORK /--- / FEES COLLECTED 8. PERMIT NUMBER - y DATE iZ--9 79 03* *30.50 *30.50 *30.50 B *0,00 85B3:2 12-03-79 ;? 6479, VALUATION 9. APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 1 JOB ADDRESS G S&S WATER DESCRIPTION - SEE ATTACHED LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. to give autho it to violate or cancel the provisions of any other stat or to al law regulating onstruction `sv Plumbing performance f cons uction. it Z' I SIGNATURE Mech. DATE OWNE [ LLL 1--A-L._-co (� �jTirtt✓C PHONE 3. ADDRESny� 1 t j �iY ZIP Required Set Backs in Feet South East West SEPA /LO,✓I`% CO T A TO 9 PH NE North Size of Parcel Zone Classification 4. Fire Marshall 3'©L D /RE S ��/ Const. Occupancy Sprinklered Yes No ❑ Req'd. ❑ [-]No DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. SEPA Checklist n THIS BECOMES — 0M j A PERMIT. n 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 %N EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF El BLD. ❑ PLMB. [IMECH: ❑ M. H. El OTHER ❑POOL CERTIFICATE Req'd. Recd. Not Req'd. WORK of EXEMPTION DESCRIBE WORK /--- / FEES COLLECTED 8. PERMIT NUMBER - y DATE iZ--9 79 03* *30.50 *30.50 *30.50 B *0,00 85B3:2 12-03-79 ;? 6479, VALUATION 9. Source of Utilities GAS ELECTRIC WATER SEWER 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 o laws and ordinances governing this Building type of work will be complied with whether specified herein or not. The gr nting of a permit does not presume I C % or the a" to give autho it to violate or cancel the provisions of any other stat or to al law regulating onstruction `sv Plumbing performance f cons uction. it Z' I SIGNATURE Mech. DATE SPECIAL APPROVALS SPECIAL COND IONS: Plan Check DEPT. REQ'D. RECD. Env. Health SEPA Planning Mobile Home Fire Marshall 3'©L Other (Specify) Co. Engineer Utilities 3�- TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist n THIS BECOMES — 0M j A PERMIT. n I DATE OFFiC,Hu - -- APPROVED FOR ISSUANCE 50. c � o *J:U