1979, 11-30 Permit: 79-8756 Plumbing 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
'0717 L. ;
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
3
OWNER
ADDRESS
107(7 ;.'3
CONTR C OR r. A�
4. 6L YV (/�,.
ADD L✓ 01 / �L1 �'✓V
I-1FS1 � ^
�a j'Yl % /f f P
5.
6.
P ONE
ZIP (}
Required Set Backs in Feet
North !South
East !West
P ONE
ZIPP9 /�
ADDREY, D i AJC�i), /4/ L
TO
CHANGE OF USE FROM
PHONE
5 177
ZIP
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
TYPE
7. OF
WORK
8.
9.
❑ NEW
❑ BLD.
DESCRIBE WORK
VALUATION
)A ALT.
A PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
Source GAS
of
Utilities
❑ MVE.
❑ POOL
❑ OTHER
ELECTRIC
Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Split Entry
No. Baths
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
Storage
No. Rooms
Rancher
Rec. Room
Req'd. Rec'd. 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 g t i. of a permit does not presume
to give authority to violate or cancel the provisions of any other state or .. reguJruction or the
performanceo construction.
DATE // C6V I�7 SIGNATURE
DEPT.
SPECIALAPPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CO 1 ITIONS:
DATE/J–G"n OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
eco
PERMIT NUMBER
DATE
03* *13.00
* 13.00 rt -
* 1 3.006
E *0,00
87552
12-06-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS113 COIXIE,S•Aj;F !MIT.d O J
((jj(b� //``JJ 875.62 *13.0O.a�
APPROVED FOR i3JUANOE —