1979, 10-30 Permit: 79-6961 Mechanical FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
8 V -,,V N y FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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 to I law regulating construction or the
performance of construction. Plumbing
DATESIGNATURE Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/OO/,)%
S
f
nnrF /0�����n Fri
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDAT
THIS�BgCOMES AP,,ERMIT.
�v
PERMIT NUMBER
G 7 Gam/
DATE �LQ >ro�
U4* *9.00
*9,00 U,
*9,OOx
B *0.00
6960-y
10-30-79
2 6479,
IS SPACE,
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB D RESS �
Z
LEGAL DESCRIPTION — SEE ATTACHED
LOT
OCK
SUB I I ON
PARCEL NUMBER/S
2.
OWNER�^
PHONE
,'a ti z
�
a —
3.
'
.J
ADDRESS
zip
Required Set Backs in Feet
North South
East West
CONTRA TO
PHONE
Size of Parcel
Zone Classification
4'
`°
ADDRES
ZIP
Type Const.
Occupancy
Srinklered
.moi
[--]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
TOG,4
Split Entry
Split Level
Rancher
6.
�
TYPE NEW �LT.
❑ AD'N.
❑ RPL. 1:1 MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ BLD. ❑ PLMB.
ECH:
❑ OTHER
ElM.H. 1-1POOLCERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
//////
of EXEMPTION
DESCRIBE WORK
8 V -,,V N y FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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 to I law regulating construction or the
performance of construction. Plumbing
DATESIGNATURE Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/OO/,)%
S
f
nnrF /0�����n Fri
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDAT
THIS�BgCOMES AP,,ERMIT.
�v
PERMIT NUMBER
G 7 Gam/
DATE �LQ >ro�
U4* *9.00
*9,00 U,
*9,OOx
B *0.00
6960-y
10-30-79
2 6479,
IS SPACE,