1979, 10-30 Permit: 79-7004 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
1.
357/ S Aix cs F
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
OWNER
&Aik or,66
71;/-904
-904
PARCEL NUMBER/S
DDRES C Ave
ZIP 954
4.
CONTRACTOR
ADDRESS
Penny Xeycr
n /m/o 4 .S/S.
P Ny-i5e' r
ZIP99-2o4
5.
ileaiditter
/'!i/YTX'' ',M✓f6 loam)? o.it
ADDRESS
O , Bev 7'9`fO
PHONE
187--7/z$
ZIP
yyzo 7
Required Set Backs in Feet
North 'South East b 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ONo 0 Req'd.
Valuation Building Area i Sq. Ft.
DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
DESCRI
$ VALUATION
9.
TO
Split Entry
Split Level
Rancher
NEW
0 ALT. 0 AD N. 0 RPL. 0 MVE.
liPLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
d,�/ie, tc.c.) / \'7''sc/rr.\s4/ /source GAS ELE/'•"CTRIC TER
of XUtilities
elsGr--//t' %74/<5
SEWER
I hereby certify that I have read and examined this applica ion 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
Ay .20
SIGNATURE (_a" _ f+divV
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/so -36- 79.
DATE OFFICIAL40 11.
-iG
0
APPROVED FOR ISSUANCE'• + —
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
f�
TOTAL $30
5
PERMIT'NUMBER
79- Toa f
DATE /G^—�o'"79
• 03* *3.Q510
*3.050 t
*3Q50'6
B *G00
70032
-1030-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. •
10NQp'U719. . 7:010,42 1%30,50'at�+
. f1
CC
0
o
1
ClZ