1979, 10-18 Permit: 79-6289 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
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
Required Set Backs in Feet
North 'South East 'West
ADDRESS
e. 73203 r -C
DESIGNER
6. ADDRESS
PHONE
YC .3YL3
D.‘7270
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ZIP
OWL Area
Basement Area 1 Garage Area •
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
ANEW 0 ALT. 0 AD N. ❑ RPL. 0 MVE.
0 BLD. C -PCMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
• CERTIFICATE
of EXEMPTION
Req'd.
Rec'ct.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
7e9ce GAS
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 conssttru tion.
DATE /077/ SIGNATURE S. -.-`f
DEPT.
SPECIAL APPROVALS
REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
z cue/
(' W
4 - cc/ v:
E1/45-18)=-79 OFFICIAL W a4CZ t/
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
z
SEPA
Mobile Home
J
CC)
Other(Spesify
TOTAL $ 2 U
P
DATE /O
PERMIT NUMBER
79-6,Z/
03* *2800
*28006
E *Q00
62888
10=18-79
N 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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