1979, 08-07 Permit: 79-1641 Plumbing FixturesrrPLAN NUMBER
Y
APPLIC ION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
i. ! Lia.G S.
LOT BLOCK
2.
O N R
3. �` '
4.
LEGAL DESCRIPTION - SEE ATTACHED
UBDIVISION
DRESS
f54 BoA �6 y 7A _
CONTRACTOR
AESS_
PHONE
q90
PARCEL NUMBER/S
Required Set Backs in Feet
North (South [East (West
PHONE
/D7
ZIP
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
D IGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area ` Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT ❑ AD'N. 0 RPL. 0 MVE.
PLMB. 0 MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE WORK
Pl u ri,.b ,' t
VALUATION
Source
of
Utllitles
111) I1 P 3 1 N P�Y��,c�
GA 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 ocal law regulating construction or the
performance .f c.nstruction.
DATE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
n C
DATE
1/
7
OFFICI
APPRO i FOR ISSUANCE
FEES COLLECTED
Single $
Building ��
Plumbing ( '�/�
)
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $3
PERMIT NUMBER
7,-- I6>4-(
DATE
03* *30.50
*3Q50
*30.506
A *0,00 8
1 64.0fi
08-07-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-07-79
16412
*3.0,50 21----) -
1
of
DATE REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
0e -CA -Ad
1P,701
• 2Q2OR
• 2020
02* •2C2C