1979, 08-29 Permit: 79-3078 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
JOB ADRESSAt
47 2 1 LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK IbUBDIVISION I PARCEL NUMBER/S
No. Baths No. Floors No. Rooms Rec. Room
TYPE 4 -MEW ❑ ALT. ElAD'N. 11 RPL. ElMVE.
7, OF ❑ OTHER Req. Recd, Not Req'd.
WORK El BLD. �RLMB. ElMECH: 1:1M.H. 11 POOL CERTIFICATE 'd
of EXEMPTION
DESCRIB ORK
8.�,�,
VALUATION Source GAS ElLeCTRIC WATER SEWER
of
9. utilities
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 to law reguIat' n co truction or the
performance of construction. %
DATE 1S > O '� 7 SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
c
DATE OFFICI�rC�
FEES COLLECTED
Single $
Building
Plumbing
Mech
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�
DATE
PERMIT NUMBER
03* *35.50
*35.50
*35,50
A *0,00
307,7
08-29-79
:@ 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM A PERMIT.
0 2 -79 0MZ
*35,50'
OWNER
PHONE
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CO R
PHONE
Size of Parcel
Zone Classification
-7Ca t'
4.
ADDRESSL
/
r"
Zyp
Type Const.
Occupancy
Sprinklered
S^ G
/L 1
/ �� f�
❑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
TO
Split Entry
Split Level
Rancher
6.
7
No. Baths No. Floors No. Rooms Rec. Room
TYPE 4 -MEW ❑ ALT. ElAD'N. 11 RPL. ElMVE.
7, OF ❑ OTHER Req. Recd, Not Req'd.
WORK El BLD. �RLMB. ElMECH: 1:1M.H. 11 POOL CERTIFICATE 'd
of EXEMPTION
DESCRIB ORK
8.�,�,
VALUATION Source GAS ElLeCTRIC WATER SEWER
of
9. utilities
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 to law reguIat' n co truction or the
performance of construction. %
DATE 1S > O '� 7 SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
c
DATE OFFICI�rC�
FEES COLLECTED
Single $
Building
Plumbing
Mech
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�
DATE
PERMIT NUMBER
03* *35.50
*35.50
*35,50
A *0,00
307,7
08-29-79
:@ 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM A PERMIT.
0 2 -79 0MZ
*35,50'