1979, 09-10 Permit: 79-3652 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
2.
3
OER
DRF
5
8/S" �.��.Lra—e_4
.-)NT CTOR
4. .
AD RE55t
/.3203 J t 4.6'
DESIGNER
6' ADDRESS
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER'S
Required Set Backs in Feet
North 'South East 'West
PHONE
72'-3gi3.
ZIP
if7��o
PHONE
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
12NEW r❑ ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 1J4LMB. 0 MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors.
No. Rooms
Rec. Room
CERTIFICATE •
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
$ VALUATIO,
9.
/v5 ce GAS
of
Utilities
ELECTRIC
WATER
SEWER
I hereby certif{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 correc . 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-constructjonpr the
performance of construction.
DATE 9—/D — 7 9 SIGNATURE
c
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
-R-9-4—Lele-wrcet-e-
fJ aL
DATE 9—/1"-7VOFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) •rl3 OG
11.1
TOTAL $LL Zd 0
P
DATE rl—/D —7y
PERMIT NUMBER
03* *2R00
*2900
*29000
- E *000 8
36S1B
09-10-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.9,:1017.9 365.2= ti2&902r2