1979, 12-26 Permit: 79-9448 Plumbing FixturesPLAN NUMBER
l
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
p
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. k4t
LOT
2.
3.
ADDRESS
4.
LOCK
OWNER
B�I I o
gikAff. c Vr
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
PARCEL NUMBER/S
—mss -
yam
ZIP
Required Set Backs In Feet
North (South East (West
CONTRACZQR
ADDRPSS
5: 12c2 13/1/V
LZESL6W68 pt �t
5. AODRr$..,
CHANGE OF U FROM
6.
TYPE
7. OF
WORK
8.
9.
PHONE
.-1-y2
ZIP
Y,
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No E Req'd.
PH NES,
Valuation Building Area in Sq. Ft.
TO
ZI;,yJ/
DWL Area I Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
❑ BLD. PLMB. ❑ MECH. ❑ M.H. 0 POOL
DESCRIBE WORK
VALUATION
Source
of
Utilities
GAS
0 OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 rcal law regulati ' construction or the
performance
f const uction. i
DATE 4 2 1 I 7 SIGNATURE ISI , a[
Mech.
4
Recd.
Not Req'd.
FEES COLLECTED
Single S
Building
Plumbing
DEPT_
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIA
Cr NDITIONS:
DATE `'/z r6FFI
APPROVED FOR ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
s _2'D
03* *2550
*25.50
*25506
B *000 0
944.72
12-26-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A P RMIT.
12-2 -7 9'
9'44.85 *25,50-o°.i11-