1979, 08-29 Permit: 79-3091 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
DESCRIBE WORK •I 44��
VALUATION Source GAS --[--ELECTRIC 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 oWcal 0:;;nstruction or the
performances of construction.
DATEy " ""�+ SIGNATURE-
SPECIAL
IGNATURE_
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE O F F I C i
FEES COLLECTED
Single $
Building
one—
Plumbing d`i
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ c7 _
PERMIT NUMBER
�� s �565
03* *2900
*2&00
*28.00
A *0.00
309.02
08-29-79
:? 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMFS A PERMIT.
0 —29-79 309.12
*28.00a�
LOT
BLOCK
Or F
PARCEL NUMBER/S
2.
]SUBDIVISION
I
OWNER
PHONE
3.
ADDRE
ZIP
Required Set Backs in Feet
North. South
East West
CONT RAC
,
PHO��
Size of Parcel
Zone Classification
4'
ADDRESS
OF
ZI
Type Const.
Occupancy
Sprinklered
c��^�
i6
❑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 1-1 NEW
❑ALT.
1-1 AD -N.
1:1 RPL.
ElMVE.
7,
OF❑OTHER
❑ BLD.
IPLMB.
E3MECH:
ElM.H.
El POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK •I 44��
VALUATION Source GAS --[--ELECTRIC 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 oWcal 0:;;nstruction or the
performances of construction.
DATEy " ""�+ SIGNATURE-
SPECIAL
IGNATURE_
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE O F F I C i
FEES COLLECTED
Single $
Building
one—
Plumbing d`i
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ c7 _
PERMIT NUMBER
�� s �565
03* *2900
*2&00
*28.00
A *0.00
309.02
08-29-79
:? 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMFS A PERMIT.
0 —29-79 309.12
*28.00a�