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