1979, 09-06 Permit: 79-3505 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
0f ,1—.K/
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
OWNER
ADDRESS
PHONE
ZIP
Required Set Backs in Feet
North 'South
East
(West
4. Q .TRACTOR Q f �/
D
• R EdZ 5'43 VA•4 /,EYW/A f
DESIGNER
5. ADDRESS
PHONE
Size of Parcel
Zone Classification
PERMIT NUMBER
-3505
DATE
03* *30.50
*30.50
*30.506
E *0.00
350,42
09 -06 -79
2 6479.
ZIP
0 3 1
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
YNEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
❑ BLD. XPLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
CRIBE WO K
L.0 i (1,1 fir /2(494'5
e4s
GAS
VALUATION Source
of
Utilities
(1/2
ELECTRIC
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 does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance off cconstructiioon.
DATE (31- ` ! SIGNATUREJ^
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
I ;ago
OFFICIA
APPROV
FOR ISSUANCE
FEES COLLECTED
Single $
Building c�/7 �^
Plumbing c� {J�
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $30'--CO
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09- 061 -79 550.52 *30.•5021
DATE REMARKS
RECORD OF INSPECTIONS
xr
Final Inspection
INSPECTED BY
=