1979, 12-26 Permit: 79-9454 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
DATE
03* *3800
*3P j0 f
*3800
B *0,00 _
945.3
12-26-79
2 6479.
DESCRIBE WORK
8 �I �z ;
APPLICANT: COMPLETE NUMBERED SPACES —
PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
t',��,� E y
LEGAL DESCRIPTION — SEE ATTACHED
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
L
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
to give authority to violate or cancel the provisions of any other state or local la regulating co C to ,Qr e
��^ U�
performance of construction.
Plumbing y�!.7
DATE/ Z —27y —72 SIGNATUR
OWNFjfj/�//�//s'W/�C—
PHONE
Mech.
3.
DEPT. REQ'D. REC'D.
Plan Check
Env. Health /4 o -So ; s;0,r�
Z�
ADDRESS
ZIP
Required Set Backs in Feet
Planning
Fire Marshall
North South
East West
Other (Specify) '0 v
CONTRACTO
F/�l- 'ABY —r,—
P ONE
s - go
Size of Parcel
Zone Classification
Zone Clearance
- -
&I E'j c
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist .
4.
/L��
�'
1 .' L U `i �'t C• li.� :I
DATLr" 0"t,IC
ADDR SS
ZI /
�.7
Type Const.
Occupancy
Sprinklered
❑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.
TYPE KNEW ❑ALT. ElAWN.1:1RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF ❑ OTHER
1:1BLD. )(PLMB. ElMECH: ElM.H. ElPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBER
DATE
03* *3800
*3P j0 f
*3800
B *0,00 _
945.3
12-26-79
2 6479.
DESCRIBE WORK
8 �I �z ;
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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 la regulating co C to ,Qr e
��^ U�
performance of construction.
Plumbing y�!.7
DATE/ Z —27y —72 SIGNATUR
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health /4 o -So ; s;0,r�
Z�
G
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify) '0 v
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist .
THIS
IB CO'7ME[S A PF,�RMIT. p
—�� 1.- '
/L��
�'
1 .' L U `i �'t C• li.� :I
DATLr" 0"t,IC