1979, 12-03 Permit: 79-8602 Mechanical FixturesFLAN 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
1.
2.
3.
JOB ADDRESS
E /Dc i‘ HOLMtW R
LOT 1 BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
ROMFSTEAP Cvn
ADDRESS
PHONE
91r7‘07s5
PARCEL NUMBER/S
ZIP
99.1.0‘
Required Set Backs in Feet
North 'South - East 'West
CONTRACTOR
4. A -I NEFlrino, 4 AIR/conlp.
ADDRESS
5.
E 4.6 WEILE
DESIGNER
PHONE -
tf9-9a�3/
99&'t
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes DNo ❑ Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
21P
OWL Area I Basement Area r Garage Area
•
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
XNEW
0 BLD.
❑ ALT.
❑ PLMB.
�❑i AD'N.
$ MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
6' In1STAL1 1.1Q k,iJAIR I1Anll7LER 4`-DUCr oRk
VALUATION Source I GA ELECTRIC
I WATER
9. Utofies
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 construction.
DATE SIGNATURE -
DEPT.
SPECIAL APPROVALS
REO'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE /2-3-79
APPROVED FOR ISSUANCE
• FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ '7. co
M
PERMIT NUMBER
DATE
04*
*7.00
*7.00 >n
*7.006
B *0.00 8
86Q1a
12=03-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12:'.-'0'3:-:719' 86Q2z A.7.0,0,aF'
cc
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