1979, 07-27 Permit: 79-1119 Plumbing FixturesL1LAN,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
1.
LOT
2.
DRECESST
LOCK IRowN�`
431.6.SDBDISIO
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
a elect 1�vss _
ADDRESS/4210 E —R ti
CONTRACTOR
4. sidee_ (o4d,X$ - LI^At..9
"DRESS
ESS
/324 N. k&
5.
DESIGNER
PHONE
ZIP
PHONE
ZIP
PHONE
ADDRESS
ZIP
Required Set Backs In Feet
North 'SouthEast 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves
ONO 0 Req'd.
Valuation Building Area in Sq. Ft.
OWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
gNEW 0 ALT. 0 AD N. 0 RPL. O MVE.
0 BLD. 0 PLMB. 0 MECH; O M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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 o violate or cancel the provisions of any other state or ocal law regulating construction or the
performance!!! c. struct .n.
DATE 2s 71 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
,Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: .
DA
TOFF
APPRo P FOR ISSUANCE
FEES COLLECTED
Single $
Building
IV
Plum ing —
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
A I -
TOTAL $'1R3
00
PERMIT NUMBER
-79--1 I I ct
DATE
03* *2300
*2100 tz
*23.00,5
A *Q.00
111.8
07=27=,7,9
fi 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THI 2/•CO S A PERMIT.
U-it.79
11192
*2'300.22
/
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
v(P)i)
•52OCQx
*Ss OC
02' • SI OP