1979, 08-15 Permit: 79-2254 Mechanical 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
1.
2.
3
JOB ADDRESS
E
LOT I BLOC SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWN
ADD fyESS-11
,
PHONE
cJPT / t
Z19
PARCEL NUMBER/S
Required Set Backs in Feet
Norttr` 'South [East 'West
4.
Ra" -{d4 [/oa
AD S .7/C' y"LCLN`wL.`'`��
PHONE
Size of Parcel I Zone Classification
ZI
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area ' Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
L!S NEW ❑ ALT.❑�/AD'N. ❑ RPL. 0 MVE.
ICI
0 BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
0 OTHER
8. SCRIB
tyzL-
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
VALUATION
9.
Source
of
Utilities
GAS
ELEC I
WATER
SEWER
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 local law regulating construction or the
performance of construction. — 2
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE` '// / ! OFF
L
FEES COLLECTED
Single $ 3,00
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
00
TOTAL $ 73 00
PERMIT NUMBER
_7,_
DATE
04* *7.00
*7.00
*7.00,5
A *0,00
22532
08-15-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-15-79
25,4`
*7,L0a;'