1979, 07-03 Permit: 79-53 Lawn SprinklerPLAN 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. / 0 ' / % ci,4 r SUBDIVISION
2.
LOT
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
3.
ADDRES
OWNER//)
S
PHONE
ZI P
PARCEL NUMBER /S
Required Set Backs in Feet
North !South LEast (West
5.
PHONE
:53.1 ---4477- 7
ZIP
/ 9t7V,/
PH ONE
Size of Parcel
Zone Classification
Type Const. Occupancy I Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
ADDRESS
ZI P
Building Area in Sq. Ft.
DWL Area 1 Basement Area Garage Area
Storage
6.
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WO RK
❑ NEW
❑ BLD.
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
XPLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
9.
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 of construction.
DATE
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 3-522
DATE
PERMIT NUMBER
79_5 -3
y /3/79
03* *550
*550 5
5,22
07 -03 -79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-03-79
5,3z *5.502
•
DATE REMARKS
n-0? -Se
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
Ca.a
0j -02-. d
02*
•220 N
,►220