1979, 10-22 Permit: 79-6474 Mechanical FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
8 -
VALUATION Source S ELECTRIC WATER SEWER
of
9. Utilities
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Single $
JOB ADDRESS
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
y 1
to give authority to violate or cancel the provisions of any other state or local regulating construction or the
'
LEGAL DESCRIPTION — SEE ATTACHED
y �, c
DATE SIGNATURE�iG 1e
LOT
BL K
SUB IVI N
SPECIAL APPROVALS SPECIAL CO ITIONS:
PARCEL NUMBER/S
2.
DEPT. REQ'D. RECD. 1,7Plan
Check
Env. Health
OWNER
PHONE
3.
J 4 'Al A
T
'.2
Mobile Home
ADDRESS
Other (Specify)
—
ZIP
Required Set Backs in Feet
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
L
3 3e F 7d
A DRESS r ._/
ZIP
Type Const.
Occupancy
Sprinklered
r Q .—
❑Yes ❑No 1-1 Req'd.
DESIGNER
P ONE
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.
TYPE NEW ALT.
❑ ❑
1:1 AD'N. ❑ RPL.
E) MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK ❑ BLD. ❑ PLMB. )� MECH: ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK
8 -
VALUATION Source S ELECTRIC WATER SEWER
of
9. Utilities
FEES COLLECTED
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Single $
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
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 regulating construction or the
'
Plumbing
performance of construction.
DATE SIGNATURE�iG 1e
7_
Mech.
SPECIAL APPROVALS SPECIAL CO ITIONS:
DEPT. REQ'D. RECD. 1,7Plan
Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
—
PERMIT NUMBER
DATE
04* *7.00
*7.00
E
647.3
10+22-79
6.479
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist2 THIS BECOMES A PERMIT.
DATE/ FICI 1 U -2 2 _.,7.•{�