1979, 12-31 Permit: 79-9685 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
1.t f'04. 4/4%
LOT
2.
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
PARCEL NUMBER /S
OVyNER/
A ESS
//PAAHONE LL
ZI P
Required Set Backs in Feet
North 'South East 'West
CONTRACTOR
6,,r2yi5
4. E'
PHONE
9' ?-0559
Size of Parcel
Zone Classification
ADD Cx Sf 2 C7 /4
DESIGNER
5' ADDRESS
ZIg9ot 0 6
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD.
DESCRIBE WORK
8.
VALUATION
9.
IKPLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
"At .6) .19 7-cic` /c,eaf_s-)
ELECTRIC
Source
of
Utilities
GAS
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
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 does not presume
to give authority to violate or cancel the provisions of any other state or to al law regulating construction or the
performance of construction.
DATE /,2 _ 3J— •r% SIGNATU
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
�, �� � �GGI'Yti • /�rQ Cdr'< �C / —� 5
SPECIAL CO,16D IONS:
ice? 3/- 79
DATE OFFICIA
APPROVED FOR ISSUAN E
FEES COLLECTED
P
PERMIT NUMBER
DATE/-
03* *25.50
*25.50
*25.506
E *000 8
96842
12 -31 -79
2 6479,
Single $
Building
Plumbing )`577
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $p2,-7 1 517
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12- 311' -79 96'8.52 *25.5Oa1:2
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
P *00