1979, 12-17 Permit: G79-9190 Mechanical 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 ADDRESS
LOT
BLOCK SUBDIVISION
il
Q>bus-bis to
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
ADDRESS
O t s 4tom l Q,N 1lv
ACWi Q
PHONE
q-(074
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East
West
4.
CONTRAC
ADDRESS
DESIGNER
AI
Ips 3O Q3 esfaxtttA�
ADDRESS
CHANGE OF USE FROM
6. Q t t�
TO
PHONE e
ZIP
PHONE
!4I
Size of Parcel
Type Const.
Occupancy
Zone Classification
Valuation
DWL Area I Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Entry Split Level
Storage
Rancher
TYPE
7. OF
WORK
D NEW IiYALT. ❑ AD'N. ❑ RPL. ❑ MVE.
O BLD. 0 PLMB. M CH: 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.
Cell1vgo.Alr4 t
DESCRIBE WOR
8.l�45 (it
VALUATION
9.
Cr ICJ
Source GAS ELECTRIC
of
Utilities
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 .cal law re(cLulating constructign or the
performance of construction.
AP
DATE {)� -112{ SIGNATURE_
•4.
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITI
DATE f247 7 OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. jIs. 0-f9
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ JZ -0-°
PERMIT NUMBER
71-q►qo
DATE 7-3b
0[t* *1200
* 1200 V)
* 12006
E *0.00
91
12-17-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12"17-T9' 919.0 Z
*120.0°�
INCPP'TfD
RECORD OF INSPECTIONS
DATE REMARKS
1
Final Inspection
INSPECTED BY
1s-1�-sa
*C ;
vt�
*1S00R
r1SJC
*1500