1979, 07-17 Permit: 79-599 Plumbing FixturesPLAN NUMBER ,
APPLICA /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
PERMIT NUMBER
JOB ADDRESS
1. of /o
LOT
2.
3
4.
-arna-( 7Z V
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
SUBDIVISION
PHONE
ZIP
PARCEL NUMBER/S
Required Set Backs In Feet
North 'South East (West
5.
CONT TOR
—0- GP
ADDRESS
I3aa3
DESIGNER
ADDRESS
6191.4-c uta. Tvt,
PHONE
9aq-sq.23
Size of Parcel Zone Classification
PHONE
/C
Type Const.
Valuation
Occupancy Sprinklered
❑Ves ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
&JEW
0 BLD.
0 ALT. ❑ AD N.
&PLMB. 0 MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.• -
Not Req'd.
DESCRIBE WORK....—. �9
8.
1S F.xnit r'
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
ors 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 ermit does not presume
to give authority to violate or cancel the provisions of any other state or loc I la ingtconstruction or the
performance of /connst/rr e/tion.
DATE 2/ / / `5 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning •
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT E7-,7- / OFFICIAL 421,411-4/41k
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
•
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
"ye" re,
03* *4050
*4050 Ui
*40506
A *000 8
5988
07-17-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISdIPf CO A AMIT.
5 59,95 *40.502p,_