1979, 11-13 Permit: 79-7671 Plumbing FixturesPLAN NUMBER
r.
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
JOB ADDRESS
1
LOT
2.
BLOCK
S BDI I ION
L S CO r gamce Lii
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
ZI P
Required Set Backs in Feet
North 'South
Ea
West
4.
CONTRACT9999 //Jj'
Mom eel tca 670.V6 .1"
PHONE
Size of Parcel
Zone Classification
ADDRESSFJ 7 .
Z99,206
Type Const.
Occu pa ncY
Sprinklered
❑Yes DNo 0 Req'd.
5.
6.
SWG44-E11
AD 1),.5F6
fl L
gc,x /yes-*/
TO
CHANGE OF USE FROM
5�6
Valuation
Building Area In Sq. Ft.
DWL Area
Split Entry
Basement Area
Garage Area
Split Level
Storage
Rancher
TYPE
7. OF
WORK
NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. ❑ PLMB. 0 MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Room
Rec. Room
CERTIFICATE -
of EXEMPTION
Req'0.
Rec'tl.
Not Req'd
DESCRIBE WORK
8.
Pt/ ria -re -3
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 correc . All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The ti g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or oc w regulating constrj. tion or the
performance f nstrucfon.
DATE 7 SIGNATURE .4 GL
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL r NDITIONS:
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing (�V
Mech.
Plan Check
SEPA
PERMIT NUMBER
b11
DATE
03* *3300
*3300 ti
*33006
B *000
767.0e
11-13-79
8 6479.
Mobile Home
Other (Specify)
TOTAL $i/V'�v�tJ��(J^/
WHEN MACHINEVALIDATED IN THIS SPACE,
A
THIS BECOMES APE MIT.
Ill'''!1'3'-.71 ' 767.12 *.33.002.0