1979, 12-26 Permit: 79-9458 Plumbing Fixtures]PLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUAI IUN Source GA5 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 not presume
to give authority to violate or cancel the provisions of any other state or loc law gulatin onstructi n o
performance of con/s'�truction.
DATE 12` 0'V '?!1 SIGNATU
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
-%--'r, k C", mss`' 3Slo�
r
r
DATE/� C _0'FFICI I _
Single $
Buildings� ����`))
Plumbing
Plan Check
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB A DRESS
i 67 41 Y
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BL=DIVISION
Other (Specif )
rY i
PARCEL NUMBER/5
2.
TOTAL $v
OWNF,R
�
PHONE
3.
Rl e S
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACT
P ONE 7
�v�Z
Size of Parcel
Zone Classification
iI _ C
*ESS
4.
ADDRESS
ZIP
` �
Type Const.
Occupancy
Sprinklered
Z0
❑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 NEW ❑ALT. ❑ AD'N. 1:1 RPL. E) MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF ❑ BLD. �PLMB. ❑ MECH: ❑ M.H. El POOL [E] OTHER
CERTIFICATE
Req'd.
Rec'd.
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
VALUAI IUN Source GA5 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 not presume
to give authority to violate or cancel the provisions of any other state or loc law gulatin onstructi n o
performance of con/s'�truction.
DATE 12` 0'V '?!1 SIGNATU
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
-%--'r, k C", mss`' 3Slo�
r
r
DATE/� C _0'FFICI I _
Single $
Buildings� ����`))
Plumbing
Plan Check
SEPA
Mobile Home
Other (Specif )
rY i
5' Q®
TOTAL $v
----7PERMIT NUMBER
DATE
-z1 * ,,
B 'Y n. o
9457'
12-26-79
6.4 ; 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.