1979, 07-13 Permit: 79-450 Plumbing Fixturesr AN 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
LOT BLC5rCIK ISUBDIV151ON I I PARCEL NUMBER/S
OWNER
3.
ADDRESS
C
4. ADDRESS
W4
5. - f ?pL
ADDRESS
L
CHANGE OF USE FROM T
6.
iONE
a,el-,Si
PHONE
ZIP
PHONE
ZIP
PE `B*NEW El ALT. ElAD'N. 1-1 RPL. 13MVE.
%, OF❑OTHER
tJORK ❑BLD. I�PLMB. ❑ MECH: [IM.H. ❑POOL
DESCRIBE WORK
8.
equired Set Backs in Feet
orth (South
ize of Parcel
77oTnstl
Occupancy
aluation
DWL Area Basement Area
Split Entry Spli
No. Baths No. Floors
CERTIFICATE
of EXEMPTION
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
_evel7 Rancher
No. Rooms I Rec. Room
Req'd. I Rec'd. Not Re(
FEES COLLECTED
VALUATION
9.
Source
of
Utilities
GAS ELECTRIC
WATER
SEWEjthis
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions in
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governiBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does not pto
give authority to violate or cancel the provisions of any other state r cel law regulating construction
performance of construction.
Plumbing
DATE ! /q ! 7q SIGNATURE
Mech.
SPECIAL APPROVALS SPEC IA C NDITIONS:
DEPT. REQ -D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
Zone clearance
SEPA Checklist
DATE
PERMIT NUMBER
-7q - V5d
DATE JU Ly��i%_
03* *41.50
*41.50
4G.92
07-13-79
2 6.479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OFFICIAAM / , n 7 —13 — 7 4 5, I,