1979, 09-04 Permit: P79-3365 Plumbing Fixtures/PLAN NUMBER
At'-" ATION/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
117/7.
BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
ADDRESS
PHONE
9.2''2c 5
ZIP
4.
CONTRACTOR�'
7% - Cg�
(4.4-�-' 14 6
D SS ; /,
DESIGNER
5. ADDRESS
PHONE
CHANGE OF USE FROM
6.
1
TYPE
7, OF
WORK
ZIP
3-7
PHONE
ZIP
TO
TrrlEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ®'PLMB. ❑ MECH. ❑ M.H. 0 POOL
0 OTHER
PARCEL NUMBER/S
Required Set Backs in Feet
North South East 'West
Size of Parcel
Type Const.
Valuation
Zone Classification
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area Storage
Split Level
Ranche
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
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 local law regulating construction or the
performance of cons uction.
DATE ± 3e'f SIGNATURE = ,y
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 9-11-71�OFFICIAL w'/ Wertz -LX -1--'
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
P
PERMIT NUMBER
79-334,5-
E
33642
09-04-79
6479.
*5500
*55.00 t
*55,00
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-04-79
336.5(5
*55,,00°)