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1979, 10-10 Permit: 79-5625 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 VALUATION 9, APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES ELECTRIC JOB ADDRESS SEWER Single $ LEGAL DESCRIPTION - SEE ATTACHED OT BLOCK SUBDIVISION to give authority to violate or cancel the provisions of any other state or local law regulating construction or the PARCEL NUMBER/S 2. Plumbing DATE SIGNATURE l2 Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. r REQ'D. RECD. Plan Check OVUR Planning PHONE 3 Fire Marshall Mobile Home Co. Engineer Other (Specify) C..CJ �ifOel�tet.� ESSlop �— Ct TOTAL $, Is— Zone Clearance C Cit/ v ZIP Required Set Backs in Feet WHEN MACHINE VALIDATE SEPA Checklist �� THIS BECOMES A PERMIT. % ':`i _ .'� DATE OFFICIAL North South East West CON ACTOR PHONE Size of Parcel Zone Classification 4. -,ADDRESS ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. FJ. ADDRESS ZIP DWL Area Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE EW E] ALT. ❑ AD'N. 1:1 RPL. I—]MVE. No. Baths No. Floors No. Rooms Rec. Room 7, OF ❑ OTHER ❑ BLD. Lr'fLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd. WORK of EXEMPTION I DESCRIBE WORK FEES COLLECTED 8 VALUATION 9, Sour&V of Utilities I GAS ELECTRIC WATER SEWER Single $ 1 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 performance of construction. Plumbing DATE SIGNATURE l2 Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. r REQ'D. RECD. Plan Check Env. Health —3 Planning SEPA Fire Marshall Mobile Home Co. Engineer Other (Specify) C..CJ �ifOel�tet.� Utilities �— Ct TOTAL $, Is— Zone Clearance C Cit/ v WHEN MACHINE VALIDATE SEPA Checklist �� THIS BECOMES A PERMIT. % ':`i _ .'� DATE OFFICIAL APPROVED FOR ISSUANCE PERMIT NUMBER DATE /2 03* *35.50 *3550 *3550 E *000 5624 10-10-79 ;F 6479, O 1 -- CD — w cZ Z