1979, 10-04 Permit: 79-5269 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
CXIEP(!. 419 LEGAL DESCRIPTION — SEE ATTACHED
L4 i Ic.�... _ I �u6Dlv�.,�v�� - PARCEL NUMBER/S
2. OWNED
3. _ CAR -,Ey CONSTRUCTION
AD, -
CONTRACTOR
4.
ADDRESS 7 y�
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
A(r
D"—.—
SPECIAL
unne
ZIP
Required Set Backs in Feet
North South
PHONE
Size of Parcel
p
Type Const.
Occupancy
PHONE
Valuation
ZIP
OWL Area
Basement Area
Split Entry
Spill
No. Baths
No. Floors
:ast IWest
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
_evel Rancher
No. Rooms Rec. Room
TYPE ^NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK 13BLD. KPLMB. ElMECH: ❑ M.H. 11POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESC I E WOR�K FEES COLLECTED
VALUATION Source GAS ELECTRIC WATERngoverning
of
9. Utilities(�
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE"luded
on reverse side, and know the same to be true and correct. All provisions of laws and ording this Building
type of work will be complied with whether specified herein or not. The granting of a permmeto give authority to violate or cancel the provisions of any other state or loc I la regula ingor �'�. CC0
performance of construction.
Plumbing
DATE �! l
SIGNA7U M h
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
GFPA r h—L,[ +
SPECIAL CONDITIONS:
ec .
Plan Check
SEPA
DATE
PERMIT NUMBER -I
G 3 L.)
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647c?
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TOTAL $Z(L_,J6
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.