1979, 09-10 Permit: 79-3650 Plumbing FixturesCLAN 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
/Sc /7 At 414,
LOT SUBDIVISION
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
OWNER
C-tw (1,177
PHONE
I `7 l�G"Gtvn
ADDRESS
CO NT
4' ADD
1T
; 6
c /
/ /� /a res; �L/,2
,[ C i
CTOR
DESIGNER
5' ADDRESS
_2(
ZIP
Required Set Backs in Feet
North 'South East
'West
PHONE
d--;(
-3335_
ZIP ;3i ry�y
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Dyes ❑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
0-'NEW 0�., ALT.
❑
BLD. N S� PLMB.
1/
❑ AD'N.
❑ 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
8.
VALUATION
9.
4C/ it,
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 » —f —71
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 does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
RECD.
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT6:1-41— 79 OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
3 3-0
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE g— / — 79
03* *3050
*3Q50 ;
*30.506
*0.00 n
E
36498
09 -10 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09- 10-79
365.02 *30.5021
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w
C/)
RECORD OF INSPECTIONS
io>
Final Inspection
REMARKS INSPECTED BY
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2Q9'
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•.2020x
'2020
02. *2020