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1979, 09-10 Permit: 79-3648 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 JOBe ADDRESS ._ LOT BLOC UBDIVrsION LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER /S 3. 16)4:1*.ilkit'11 172 ( ADDRESS 4. CONTriCTOR iT /- P1inX" PHONE ZIP PHONE —3�YS' Required Set Backs in Feet North 'South [East IWest Size of Parcel Zone Classification ADDRESS c 'i LJd'r c i _740 DESIGNER ZIP, Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. PHONE Valuation Building Area in Sq. Ft. ADDRESS ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK (rNEW ❑ BLD. ❑ ALT. ❑ AD N. LJ,, <MB. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK VALUATION 9. / C /L/J ource GAS of Utilities 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 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 G- 7 ?OFFICIA APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing1� —f Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ p PERMIT NUMBER 75 -,36 `%e" DATE q—/Z)— 7 9 03* *2550 *2550 *2550 E *0.00 36478 09 -10 -79 2 6479. d` O 1— U — w 0 WHEN MACHINE VALIDATED IN 7riIS SPACE, THIS BECOMES A PERMIT. 09 -10 -79 364.8(5 *25,.5.0a� DATE REMARKS RECORD OF INSPECTIONS Final Inspection INSPECTED BY eaaa 0d -J0 -Ad 29 E *000 2 *5220Q 02* *5220