1979, 12-04 Permit: 79-8654 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PPERMIT NUMBER
DATE
03* *28.00
*2'ut)0
8653
12-04-79
6479.
8 '!S
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.LOT
JOB DDRESS
_�a{i �C
la
n
;
LEGAL DESCRIPTION — SEE ATTACHED
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
BLOCK
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
PARCEL NUMBER/S
2.
Plumbing
DATE SIGNATURE—
ISUBDIVISION
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
OWN
a
SEPA
PHONE
3.
MobileHome
Engineer
_ Il�
Co.
they (Specify►
Utilities
ADD^^ ESS �`
be
TOTAL
Zone Clearance
ZIP
Required Set Backs in Feet
WHEN MACHINE VALIDATED IN THIS SPACE,
aC J 42` h I
V �
DATE �� y 7—OFFICIAL
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North South
East West
CONTRACTOR i
A %
PHONE
--37'U
Size of Parcel
Zone Classification
jv yl!!
4.
AD ES A
ZIP /
Type Con;Tj
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
T Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW 1-1 ALT. 1-1AD'N.
El RPL.
11MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
El OTHER
❑ BLD. ❑PLM B. ❑ MECH:
❑ M.H.
❑POOL
CERTIFICATE
Req'd.
Recd,
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
f
PPERMIT NUMBER
DATE
03* *28.00
*2'ut)0
8653
12-04-79
6479.
8 '!S
FEES COLLECTED
—uecVALUATION Source GAS ELECTRIC WATER SEWER
of
9, 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 not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning,
Fire Marshall
MobileHome
Engineer
_ Il�
Co.
they (Specify►
Utilities
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PEWMIT. /� p
2` 0 `t * 2 C it il_ F
DATE �� y 7—OFFICIAL
1 fi