1979, 12-11 Permit: 79-8920 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. 5 350/ GO(
LOT BLOCK
2.
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
�7t u e P6/61A-Ze
P#'j3J-'167)
PARCEL NUMBER/S
ADDRESS ,
ZIP
Required Set Backs in Feet
North 'South East West
CONTRACTOR
A\i6 G/— vi6fM
ADD lOfBoX 7'/fd
DESIGNER
6' ADDRESS
PHONE
4y 7/z&
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area i Sq. Ft.
ZIP
DWI_ Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
APLMB
❑ AD'N.
O MECH
❑ RPL.
❑ M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/1 ,G/,'714X 5
GAS
Source
of
Utilities
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.///J�
DATE /2 — // SIGNATURE 1 "/�—
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D-
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
—//— 79
DATE
OFFICIAL '\4/44/.t4r�r.I
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
5
Plumbing JO -/
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$JO
TOTAL
P
PERMIT NUMBER
79-8994
DATE 79
03* *3050
*3050 >n
*3Q506
E *000
89'1.92
12-11,-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12H- -11-11'9' 8'92.02 *3115t0iapi