1979, 11-01 Permit: 79-7106 Plumbing FixturePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT
2.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
LOCK SUBDIVISION'S
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
3 A-Ro N ..'20 c�crrc)
ADDRESS ^'
So c 7ty° 907 .664-/2411 'P/J(J
CT
CONTR TOR
4. P/b7 —Z jc.
ADDRESS
,Ast / 22 a5710N
PHONE
ZIP
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
DESIGNER
5.
ADDRESS
6.
CHANGE OF USE FROM
TO
ZIP
q 1.707
PHONE
Type Const.
ZIP
Valuation
Occupancy
DWL Area I Basement Area
Split Entry
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
Storage
Rancher
TYPE
7. OF
WORK
❑ NEW
D BLD.
DESCRIBE O K
8. VALUA ION`
9.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
o�
;(4-ct42
Not Req'd.
Source
of
Utilities
GAS
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 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 OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
' Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ...J, 5-0
DATE
PERMIT NUMBER
-4 - 1!o6
/40.-2-79
C3* *550
*550
71 052
11-01-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1;1 �0E-179 7 10.6 z
*5.50°