1979, 08-06 Permit: 79-1590 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 ADDRESS
`1
JN
LEGAL DESCRIPTION — SEE ATTACHED
1. E - / C1
GAS
ELECTRIC
WATER
SEWER
LOT BLOCKjSUBUIV`ILdUN
of
Utilities
PARCEL NUMBER/S
2. I
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 Building
OWN
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the O J�
PHONE
3.
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
ADDRE S
Env. Health
ZIP
Required Set Backs in Feet
Planning
/
7 GJ/
•CTO
TOTAL $
Zone Clearance
North South East West
CON
WHEN MACHINE VALIDATED
�r
3 � 510�,
PHONE
Size of Parcel
Zone Classification
4.
ADD
ZIP
Type Const.
Occupancy
SSS w'`�
V
Vcf,03 7
❑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.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW 11ALT.
1:1AD'N.
❑ RPL.
❑ MVE.
7, OF,_/
❑OTHER
1:1 BLD. LPLMB.
❑ MECH:
❑ M.H.
El POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBER
DATE
* *30.50
*30.50
*3050
A *000
15898
08-06-79
;F 61479.
DESCRIBE WORK
i
FEES COLLECTED
8
JN
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
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 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 law regulating construction or the O J�
Plumbing
performance of construction.
9
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities J�
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A PERMIT'.
� _ ��„� (, � — (� �
J J /
3 � 510�,
DATE�7� OFFICI