1979, 12-13 Permit: 79-9032 Plumbing FixturesPERMITyVUMB ZIO3a_
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY --BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / 'SPOIeANE, WASHINGTON 99260 / (509) 456-3675
-,'APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1.
3.
LOT
OWNER
• BLOCK
UBDI VISr0IS e-010/ ' ! T7
LEGAL.DESCRIPTION - SEE ATTACHED
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
Required Set Backs in Feet
North 'South
East
'West
CONTRAC R
4. �.-4- Cn//;ks
ADDRESS nn
/U1
ii210
n,
bE-646AiEB-
5.
6.
PHONE
yah
9aiz,
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
bSE9Ft76
Valuation
Building Area in Sq. Ft.
ADDRE
�. USE /ytr,Y
CHANGE OF USE ROM O
ZIP,7a/y
OWL Area I Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
ANEW
a BLD.
❑ ALT. I] AD'N. 0 RPL.
KPLMB. 0 MECH: 0 M.H.
0 MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
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 ' a ing of a permit does not presume
to give authority to violate or cancel the provisions of any other state .4.:]� aw regulating cgfjstruction or the
performance of onstru�ti
tion.
DATE /af// L, SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIALS DITIONS:
DATE ta-13-”OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
2
DATE
03* *37.5.0
*37.50 15
*37.5.08
E *GOO 8
90318
12-13-7.9
8 6479.
Building '� c
Plumbing 32,5 V%%
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BCO 1, MIT.
122, .:1 9'03.22 *373,0TO