1979, 12-04 Permit: 79-8662 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
10717 E- 2-3>
JOB ADDRESS
LOT BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
OWNER e/ /6.,/i iL(.. l'/-
CONTRACR
P ONE
�' "Pa
ZI P
PHONE
,.-772
047_
PARCEL NUMBER/S
Required Set Backs in Feet
North
South
East IWes
Size of Parcel
ADDRE
7
DESIG`R
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
Clf1`% 216
PHO E
Type Const.
Occupancy
ZI P
TO
❑ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. CPLMB. ❑ MECH. ❑ M.H. 0 POOL
DESCRIBE WORK
/6 ,
❑ OTHER
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
Valuation
DWL Area
Split Entry
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Basement Area
Building Area in Sq. Ft.
Garage Area
Storage
Split Level Rancher
No. Floors
CERTIFICATE
of EXEMPTION
WATER
No. Rooms
Rec. Room
Req'd. Recd.
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 d es not presume
to give authority to violate or cancel the provisions of any other state or local .w reg ng constructi'n or the
performance of construction.
DATE
2x/71:
SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
I- 54 e'l
TO 1 ie
� ast,J
DATE
OFFICIAL / cr-wirt-t57%-,
APPROVED FOR ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Meth.
Plan Check
SEPA
Mobile Home
C
O her (Specify) -4i 447
TOTAL $/0, ✓
DATE
PERMIT NUMBER ^
12----3 77
03* *1050
* 1 0,50
* 10506
E *0.00
86618
12-04-79
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12-04:-79 866.25