1979, 09-10 Permit: 79-3619 Plumbing FixturesPLAN NUMBER
6
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 .- LEGAL DESCRIPTION — SEE ATTACHED
,. �/y;?/ S l',///S
PERMIT NUMBER
DATE
03* *3Q50
*3050
*30508'
A *000
361.82
09-10-79
;F 6.479.
r,' v . ? 67 N / 012 Y�• �T - ,Q rcco i cu
OWNER
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities Single $
PHONE
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
3.
A
�N
to give authority to violate or cancel the provisions of any other state o Cal law regulating construction or the
performance of construction. Plumbing
DATE �V 71 SIGNATURE
ADDRESS
SPECIAL APPROVALS SPECIAL CONDITIONS:
ZIP
Required Set Backs in Feet
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
North South
East West
CONTRA TOR
TOTAL $ `^
PHONE,5-!-F (�O
Size of Parcel
Zone Classification
IN THIS SPACE,
SEPA Checklist THIST6C011( A�E�MIT.
jj 7
DATE�9-OFFICI
6 I.9 53,
...
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
�^^
J / G
r
e G
/ ��
/
ft;? 'i Y
❑Yes ❑ No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE � NEW
❑ALT.
ElAD'N. El RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
El BLD.
�/
/7 PLMB.
F-1MECH: ElM.H.
El OTHER
1:1PO0L
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBER
DATE
03* *3Q50
*3050
*30508'
A *000
361.82
09-10-79
;F 6.479.
r,' v . ? 67 N / 012 Y�• �T - ,Q rcco i cu
VALUATION Source GAS ELECTRIC 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 o Cal law regulating construction or the
performance of construction. Plumbing
DATE �V 71 SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. , 1< f �f<S Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)—
Utilities
TOTAL $ `^
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIST6C011( A�E�MIT.
jj 7
DATE�9-OFFICI
6 I.9 53,
...
*30.50°