1979, 10-17 Permit: 79-6117 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
A 3 DESCRIPTION SCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBUIVISION I PARCEL NUMBER/S
No. Baths No. Floors No. Rooms I Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. /ifr
7, OF 1:1OTHER
WORK 11 BLD. %PLMB. ElMECH: ❑ M.H. ❑POOL CERTIFICATE
of EXEMPTION
D SCRIBE WORK
8. V /e / Q r -),Y. t u r2 ee,.
VALUATION Source GAS ELECTRIC WATER SEWER
of ,
9. Utilities
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 , " V "" SIGNATUREtl
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL APPROVALS SPECIAL CONDITIONS:
REQ'D. RECD.
SEPA Checklist , 1 �
f 9 ec/ DATFS/C�_�%i —;V OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
DATE Id
03* *28.00
*2800
*2800X
E *0.0C
61 1,6
10-17-79
64.79,
i3
TOTA L $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i. .� `l 1
*28,010;
OWNER
PHONE
a
Z-/- ptZ.
3.IP
A DRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
6onli
49 I - 0,rr7.
4'
ADDRESS
ZIPType
Const.
Occupancy
Sprinklered
r
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
OWL Area
Area
Garage Area
Storage
I
[Basement
CHANGE OF US FROM TO
Split Entry
Split Level
Rancher
6.
No. Baths No. Floors No. Rooms I Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. /ifr
7, OF 1:1OTHER
WORK 11 BLD. %PLMB. ElMECH: ❑ M.H. ❑POOL CERTIFICATE
of EXEMPTION
D SCRIBE WORK
8. V /e / Q r -),Y. t u r2 ee,.
VALUATION Source GAS ELECTRIC WATER SEWER
of ,
9. Utilities
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 , " V "" SIGNATUREtl
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL APPROVALS SPECIAL CONDITIONS:
REQ'D. RECD.
SEPA Checklist , 1 �
f 9 ec/ DATFS/C�_�%i —;V OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
DATE Id
03* *28.00
*2800
*2800X
E *0.0C
61 1,6
10-17-79
64.79,
i3
TOTA L $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i. .� `l 1
*28,010;