1979, 12-31 Permit: 79-9658 Plumbing FixturesPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LO it6LOOCK SUBDIVISIL,N
3.
OWN
'-e C fr
ADDRESS
CONTRACT R
-7/\T. b- ant fe►' ' .: sic
4. ADDRESS E TreAI �-
DESIGNER
5. ADDRESS
PHONE
ZIP
P ONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Required Set Backs in Feet
North !South lEast 'West
Size of Parcel
Zone Classification
Type Const.
Occupancy
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
TYPE
7. OF
WORK
VEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ BLD. XPLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors No. Rooms
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE Req'd.
of EXEMPTION
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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
type of work will be complied with whether specified herein or not. The granting of a permit d• • presu
to give authority to violate or cancel the provisions of any other state or lo c. law - lati. ••nstruction
performance of construction. 0 if
DATE /Z 27— 747 SIGNATU
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Ut Iities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
13-
S0
z, S.0
DATE %.Z /. I/ 79 OFFICIAL Gd
APPROVED FOR ISSUANCE
Rec'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home �q
Other (Specify) o D
TOTAL $ dSC
DATE
PERMIT NUMBER
/Z-27-71
03* *3550
*3550
*35.506
E *000
96572
12 -31 =79
2 6.479.
U
— w
a
rn
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12 -3 "1'=79 9`65,8= *35.50 :2.)
DATE REMARKS
.t-
i
T
RECORD OF INSPECTIONS
•
Final Inspection
INSPECTED BY
1S -21-Jd