1979, 10-19 Permit: 79-6396 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
FEES COLLECTED
JOB ADDRESS
A/(f ����
VALUATION
LEGAL DESCRIPTION - SEE ATTACHED
1.
J, a/
14 �
SEWER
9.
LOT BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
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
OWNER
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
PHONE
-#y
3.
4 /&
((
DATE /% SIGNATURE)!`
Mech.
SPECIAL APPROVALS
ADDRESS
DEPT. REQ'D. RECD.
ZIP
Required Set Backs in Feet
Env. Health
North South
East West
CONTRACTOR
Fire Marshall
PHONE
Size of Parcel
Zone Classification
Other (Specify)
Utilities
TOTA L $ s
4'
WHEN MACHINE VALIDAT
SEPA Checklist
/
THIS BECOMES A PERMIT.
ADDRESS
/
YY,�
ZIP '-7
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑
,f
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
El ALT. 11AD'N. El RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF1:1OTHER
❑ BLD.
rr��rr
yy PLMB. ❑ MECH: ❑ M. H.
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd..
WORK
of EXEMPTION
DESCRIBE WORK
^
8. s, 'xi 2 � n
FEES COLLECTED
, -5
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
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
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
-#y
performance of construction.
Plumbing
((
DATE /% SIGNATURE)!`
Mech.
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 $ s
Zone Clearance
WHEN MACHINE VALIDAT
SEPA Checklist
/
THIS BECOMES A PERMIT.
DAT FiZ�1`�{if)FFI CIAL-LL[..i,�2.s�LL-' GZ ,.'�t. "l.il '��.
/
PERMIT NUMBER
DATE/'-')
03* *,3.00
*33.00
*33.00."
E * C,
L'
639.5
10-19-79
6<'17 9,
IN THIS SPACE.
I