1979, 10-17 Permit: 79-6138 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
PARLEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER
PHONE
9n
3. �—
AD RESS
ZIP
Required Set Backsin Feet
-,Do
North South
East West
1C TRACTOR
PHONE
Size of Parcel
Zone Classification
7
-4101
4.
A RESS
ZIP
Type Const.
Occupancy
Sprinklered
(j%
❑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. El AD'N. El RPL. ❑ MVE.
"11
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF El OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
❑ SLD. XPLMB. ❑ MECH: ❑ M.H. 11 POOL
WORK
of EXEMPTION
DESRIBE WORK
C
8 T
`
FEES COLLECTED
VALUATION'
Source
AS
ELECTRIC WATER
SEWER
9.
ofT
Utilities
Single $
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
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 const uction.
Plumbing
A
DATEJo SIGNATURE _
Mech.
' SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Plan Check
3.00 SEPA
430,50Mobile Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDAI
THIS BECOMES A PERMIT.
DAT -/-/O FFICIAL,,:L.ft� �`../ =��� �. �. 1/ y
Annnnvrn rnn 1oo11Aninr
PERMIT NUMBER
,01 7-
DATE/J �
'�
03* *30.50
*3050
*30,50
E *0.00
61372
10-17-79
-Q 6.479,
i
SPACE',
;r. *30.50°
I