1979, 12-31 Permit: 79-9656 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
1.
2.
3.
JOB ADDRESS
LOT BLIOC
OW�
ADDRESS
SUBDIVISION
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South
East
'West
CONTRALTO �
`
T
4.
AD/74E-so
7 L- TYeu>L-
DESIGNER
5' ADDRESS
P ONE
1zt 9v f z
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Des ❑No ❑ Req'd.
PHONE
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
EW ❑ ALT. ❑
❑ BLD.
'PLMB. ❑
AD'N. ❑ RPL. ❑ MVE.
MECH: ❑ M.H. El POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE )7"—Z 7r
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit d.- • _ •sume
the provisions of any other state or local w regulati constru • • e
SIGNATU iaid.
SPECIAL APPROVALS
DEPT. REQ'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
R EC' D.
one Clearance
SEPA Checklist
SPECIAL CONDITIONS:
13-
37 J0
r"
DATE /,�1.3/ C� OFFICIAL t.#
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 32 -S6
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)40
TOTAL $ 3S•Sa
PERMIT NUMBER
5 (U
DATE
03* *35.50
*35.50
*35,506
E *0.00 8
965.5
12 -31 -79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 2 '- ► S 1 - 749' 9 '6 5.6
*35.50 °.1
DATE
RECORD OF INSPECTIONS
Final Inspection
REMARKS INSPECTED BY
•
1 s-21—.16
6922`a
*L'e )07
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