1979, 07-06 Permit: 79-155 Plumbing FIxturesPI 4N NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
PERMIT NUMBER
79-- IS
03* *38.50
*38.50 L
15,42
07-06-79
6,479,
VALUATION Source GAS ELECTRIC WATER SEWER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
,
Single $
JOB ADDRESS
�,/�
Building
LEGAL DESCRIPTION -SEE ATTACHED
1.
S
/,2/S 1 ca
ri"
it
DATE V SIGNATURE z
LOT
BLOCK
SUBDIVISION /
DEPT. REQ'D. RECD.
PARCEL NUMBER/S
2.
02
1i/I 1 Ccc P",
+ni cl
Fire Marshall
Mobile Home
OWNER
Other (Specify)
Utilities
PHONE
TOTAL $
3.
t
<
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
F7 6
DATE OFFICIAL_
ADDRESS
/
ZIP
Required Set Backs in Feet
/,V09
f(
�f
2j
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type ConsT7
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
&F9PFER
P �,
PHONE
Valuation
Building Area in Sq. Ft.
S- S'?C
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE
FROM
TO
Split Entry
Split Level
Rancher
6.
,}�
TYPE NEW
1-1 ALT. El AWN.
1:1 RPL.
1-1 MVE.
No. BathsT
No. Floors
No. Rooms
Rec. Room
7,
OF /
❑ OTHER
❑ BLD.
❑ MECH:
❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
�PLMB.
of EXEMPTION
I
DESCRIBE WORK
8
FEES COLLECTED
DATE
PERMIT NUMBER
79-- IS
03* *38.50
*38.50 L
15,42
07-06-79
6,479,
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 1 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
SS'i rte.
jG�
performance of construction.
Plumbing
DATE V SIGNATURE z
_
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
�11 Ft -x
77
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS rBEOCOME�S A PERMIT.
U ((77 9 15. 5 2 * 3 8. 5 0 O F
DATE OFFICIAL_