1979, 08-10 Permit: 79-1980 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
$ S-4��FEES
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
GAS
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
WATER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
9.
JOB ADDRESS
1tQ10
LEGAL DESCRIPTION - SEE ATTACHED
1.
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
LOT
BLOCK
SUBDIVISION
type of work will be complied with whether specified herein or not. The granting ermit does not presume cels
PARCEL NUMBER/S
2.
I
I—/
OWNER I
PHONE
3.
/�•y�w//y'
Env. Health
SEPA
ADDRESS
Planning
ZIP
Required Set Backs in Feet
0,2
Utilities
North South East West
TOTA L $
CONT T
Zone Clearance
PyQNE
Size of Parcel
Zone Classification
1
14
0DATE/0/�6(
4.
ADDRESS 2/�
Z 2Z
Type Const.
Occupancy
Sprinklered
-]yes
•��"��
❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW ❑ALT. El AD'N.
❑ RPL. MVE.
❑
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF, `
❑ BLD. K-PLMB. ❑ MECH:
❑ OTHER
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DATE
PERMIT NUMBER
03* *38,00
*3800
*38:00
A *GOO
197,92
08-10-79
2 6.479.
DESCRIBE WORK
COLLECTED
$ S-4��FEES
VALUATIONSource
GAS
ELECTRIC
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 ermit does not presume cels
to give authority to violate or cancel the provisions of any other state or to regulat ng construction or the 39
Plumbing
performance of construction.
j�,�
I—/
DATE SIGNATURE Mech.
i
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other(Specify)
Utilities
TOTA L $
Zone Clearance
WHEN MACHINE VALIDATED
ALIDATED
SEPA Checklist THISBUCOMESAPEMIT.
O — 0�
IN THIS SPACE, PACE,
Q'
1
14
0DATE/0/�6(
*38.O0EOL r