1979, 07-20 Permit: 79-821 Plumbing FixturesL-'LAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES — P
RESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LO B •CK
2. 7A
3.
SUBDIVISION
OWNER
r"- y �,L s,—
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
PARCEL NUMBER /S
ZIP
Required Set Backs in Feet
North !South
East
(West
4.
ADDRESS
CONTRA\`CCTTO
ADDRESS
/ ///i 7
DESIGNER
5' ADDRESS
E /e- ✓ /r►3eS 'L
T
P ONE
- O42
Size of Parcel
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
KNEW ❑ ALT.
❑ BLD. XPLMB.
❑ 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.
8.
DESCRI E WORK/
Source
of
Utilities
VALUATION
9.
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
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
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 do • • pre . e
the provisions of any other state or local law r•gulati co struction or t
SIGNATURE
SPECIAL APPROVALS
REQ'D.
REC'D.
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFICIAL
nPPPnvFn FnP ISSIIAN(F
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) 3 Va
TOTAL 6v
DATE
PERMIT NUMBER
7//1 7/7,
03* *35,50
* 35.50 N
* 35,506
A *000 8
8202
07 -20 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIScr,COPI E,S A
82.1°
*35.50 °�
REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
S. Vctld
04-5n — ,itt
6501
V
02.•
.000
*22208
.2220
*2220