1979, 09-24 Permit: 79-4554 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
JOB „D�/ ✓ 6'e/ied
OT BLOCK SUBDIVISION
7ER,
�3ADDRESS
/a9 '9 9/2r. 9L e e.
CON ACTOR
LEGAL DESCRIPTION — SEE ATTACHED
4- SS
6/ADO
l/
5.
DESIGNER
f 'kms,
PHONE
Z 199
PARCEL NUMBER/S
Required Set Backs in Feet
North
South East
West
PHONE
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
❑yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry Split Level
Storage
Rancher
TYPE
7, OF
WORK
I41• 1.rw �❑I ALT. ❑ AD'N. 0 RPL. 0 MVE.
e
Br—`LD. I'rMB. 0 MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC
8.
W RK
2//l0/a/
VALUATION Source
of
9. 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 I w regulating construction or the
performance of construction.
an
DATE / 2%` 7� SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATI17-21_ 74FFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building y
Plumbing .33 (T
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
PERMIT NUMBER
P 79-'/ 5-'
Payl9
03* *3300
*3300 v~i
*3300e
E *Q00 8
45538
09-24-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS CO E APE MIT.
2
U - 44-7 45542 *33.00
O
a t-
DATE REMARKS
RECORD
OF INSPECTIONS
Final Inspection
INSPECTED BY
0a-sa-1a
¥000
•2'00.
*2200
023 .2700
1