1979, 11-05 Permit: 79-7269 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
f� LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION I PARCEL NUMBER/S
OWNER
3.
ADDRESS
CONTRAC
4. ADORES
DESIGNER
5. ADDRESS
R
I.,
CHANGE OF USE FROM ITO '-
6.
PHONE
ZIP
Required Set Backs in Feet
North South East West
PONE
Size of Parcel
Zone Classification
1'
FEES COLLECTED
8 •'`
ZIP
Type Const.
Occupancy
Sprinklered
EL CTRIC WATER SEWER
[--]yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP OWL Area I Basement Area Garage Area Storage
Split Entry Split Level Rancher
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OFElOTHER
71 --r-1 P "M ECH ❑ M H ❑ POOL _ CERTIFICATE Req'd. Recd. Not Req'd.
PERMIT NUMBER
-7Z6
DATE Z 1 _3_ 79
04* - *9.00
*900 n
*9.006
E *000 8
7268;
11 -05.=79•
@ 6479.
WORK BLD. L B. N /
// ``
-
of EXEMPTION
DESCRIBE WORK
'_
FEES COLLECTED
8 •'`
VALUATION
Source GAS
EL CTRIC WATER SEWER
of
9,
Utilities
Single $
1 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
Building
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.
Plumbing
SIGNATURE
7,—
DATE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning .
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance.
IN THIS SPACE,
WHEN MACHINE VALIDATED
- SEPA Checklist �/ – Jt – -7 17
THIS •A
�jBECOMES 7PERMIT.
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DATE OFFICIALAI r��.f�I�VO�GZ�ZC/W`��
APPROVED FOR ISSUANCE
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