1979, 10-10 Permit: 79-5660 Plumbing FixturesBuilding Area in Sq. Ft.
'PLAN NUMBER
1
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 ADDRESS
/ro� S L LL e Up+
LOT BLOCK SUBDIVISION
OW R
3.k'iei:I\P4-fl'•)
A RESS
CONTRACTOR
4. ,\I
t` l U YYv
D ESS
AD
11O'7 1okcioke
vl
DESIGNER
5.
LEGAL DESCRIPTION - SEE ATTACHED
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
9.
PHONE
ZIP
ZIP
PHONE
ZIP
TO
NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
❑ BLD. 0 PLMB. ❑ MECH: 0 M.H. ❑ POOL
DESCRIBE WORK
VALUATION
❑ OTHER
PARCEL NUMBER/S
Required Set Backs in Feet
North South East 'West
Size of Parcel
Type Const.
Valuation
DWL Area
UM
Sour
of
Utilities
GAS
J
ELECTRIC
Basement Area
Split Entry
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Garage Area
Storage
Split Level Rancher
No. Floors No. Rooms
CERTIFICATE
of EXEMPTION
WATER
Rec. Room
Req'd. Recd.
Not Req'd.
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 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
FEES COLLECTED
Single $
Building
Plumbing .;,��0
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify) 360
r7i1
o�
TOTAL $=
PE Irt,MiT,NUMBER
DATE
04* *2800
*2800
*28.006
E *Q00
56592
10-10-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 x-.11 0 -'7 9
566:0, *28,00oR