1979, 09-17 Permit: 79-4098 Plumbing FixturesSize of Parcel
PLAN 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 ADDR SS
1. ._ , J,/ C�GCI ii,11
LOT BLOCK SU IV O
I ON
2.
3. 13134,
ADDRESS
PHONE
ZI P
5' ADDRESS
CHANGE OF USE FROM
T
PHONE
ZI P
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South
Type Const.
TYPE
7, OF
WORK
LEW ❑ALT..
D.
LM B.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Occupancy
East
Wes
Zone Classification
Valuation
DWL Area
Split Entry
No. Baths
Basement Area
Sprinklered
❑Yes ❑No El Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
Storage
Rancher
Rec. Room
Req'd. Rec'd.
9.
VALUATION
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
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
DEPT.
Env. Health
Plann ing
Fire Marshall
Co. Engineer
Utilities
SPECIAL APPROVALS
REQ'D.
REC'D.
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE / 14/ OFFI
AP'' FOR ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
f2
PERMIT NUMBER
`9 - + 22'
03* *4300
*4300 to-
*43006
A *0.00
40978
09 -17 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09- '17 -7.9
409,82 *43.00°H
RECORD OF INSPECTIONS
DATE REMARKS
Final Inspection
INSPECTED BY
. 06-1a — .16
V
00C
aAr2o0
02* *tt2'00