1979, 10-18 Permit: 79-6293 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
VALUATION Source GAS 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 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 constr ction.
DATE SIGNATURE4L
SPECIAL
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/r�U✓ U
DATEZel �-790FFICIAL�
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specif 3G�
TOTA L $.`Z --^-
i
PERMIT NUMBER
DATE
03* *3550
*35,50
*35.50
E *00%
629.22
10-18-79
g 6 Ll 79,
WHEN MACHINE VALIDATED IN THIS SPACE.:,
THIS BECOMES A PERMIT.
10—.'18-7(",'9.7
*)7501,01,.1
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
JOB A DRESS
O/L
`.
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
OWNER
PHONE
3.
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CON ACTOR
PHONE
Size of Parcel
Zone Classification
4'
ADDRESSx
ZIP
Type Const.
Occupancy
Sprinklered
112.0-3�{
❑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. 1-1 AD -N.
1:1 RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
El OTHER
❑ BLD.PLMB.
❑ MECH:
❑ M.H.
El
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
VALUATION Source GAS 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 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 constr ction.
DATE SIGNATURE4L
SPECIAL
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/r�U✓ U
DATEZel �-790FFICIAL�
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specif 3G�
TOTA L $.`Z --^-
i
PERMIT NUMBER
DATE
03* *3550
*35,50
*35.50
E *00%
629.22
10-18-79
g 6 Ll 79,
WHEN MACHINE VALIDATED IN THIS SPACE.:,
THIS BECOMES A PERMIT.
10—.'18-7(",'9.7
*)7501,01,.1