1979, 10-11 Permit: 79-5817 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / 1509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
S Saga 304- /c.1" i�/14J• /r
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWNER
s. A; k,y,' /s f 5. -/‘s 7 •'r r4„ "n 4r
ADD
S
423CONTRACTOR5 F(,�r,p,-erl //ri </•-, el -/4-1--C
4. ,4,/, /! %, Je 1 n 7`0., — t/././:99, f �v ¢
ADDRESS
//r,a t4 /r, 6,../Kr lr
/7_30/2 —2 t'
DESIGNER
5' ADDRESS
PHONE
1242 —
ZIP
Required Set Backs In Feet
North [South 1East [West
PHONE
W �ai3
Size of Parcel 1 Zone Classification
ZIP
19,77
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in 5q. Ft.
ZIP
OWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
&} NEW
0 BLD.
0 ALT.
{ PLMB.
❑ AD'N.
O MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/1
Source
of
Utilities
GAS
A ><L!C/S
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 �4/ /?9. SIGNATURE raiz, 74*
DEPT.
_4
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planrfng
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
o;
FEES COLLECTED
Single $
Building
Plumbing lJ0
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $7,C.= eQ
f
PERMIT NUMBER
DATE
03* *38.00
* 3800
* 38006
E *000 8
581.6B
10-11-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. *.D 0 a,F
101—I1 '1"-'7t9 5'81, 7 z