1979, 12-26 Permit: 79-9456 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
LEGAL DESCRIPTION —SEE ATTACHED
1.�� MCI
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
OWN(JU�/ �S
PHONE
3.
ADDRESS
ZIP
Required Set Backs in Feet
North South East West
CONTRACTOR/�
PHONE
C
Size of Parcel
Zone Classification
Jam. lS'f'
'" ,
4.
ADDR S
ZI q 7 /
Type Const.
Occupancy
Sprinklered
'ago 7
! �e
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW ALT. ❑ AD'N. 11 RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
ElBLD. XPLMB. ❑ MECH: ❑ M.H.
OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
� �
Z �/ FEES COLLECTED
`
8.
T �iC�
VALUATION
Source
GAS7-7
RIC
WATER
SEWER
9.
of
Utilities
Single $
1 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 ume
to give authority to violate or cancel the provisions of
any other state or local la regula g con ruction oLAe ��
Plumbing
performance of
..
-construction.
j
DATE ���-/
SIGNATU Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health
j i1 Ft A s i Z�, O�
f '7 ,J
SEPA
Manning
Fire Marshall
Mobile Home
Co. Engineer
O er (Specify) 3'00
Utilities
TOTAL $ >+�
Zone Clearance
WHEN MACHINE VALIDAT
SEPA Checklist
THIS BECOMES A PERMIT.
DATE
PERMIT NUMBER
P -�-
DATE j2 ' 2,a 7 cl
&
v 7 C
P
945,5
12-26-79
6 It 79,