1979, 11-08 Permit: 79-7495 PipingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB :1RE�
1. �/� /J
APPLICANT: COMPLETE NUMBERED SPACES -.PRESS HARD TO MAKE 4 COPIES
2.
3.
LOT
BLOCK
6�
SUBDIVISION
A liS 7/ t C"
Day
c
RESS
/27/0
DESIGNER
5. ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1'9:2/6
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South (East 'West
Size of Parcel I Zone Classification
Type Const.
Occupancy
-- Sprinklered ---
DYes DNo 0 Req'd.
Valuation I Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area f Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE 0 NEW
7, OF
WORK D BLD.
❑ ALT.
❑ PLMB.
LJ AD N.
0 MECH
D RPL.
❑ M.H.
D MVE.
D POOL•
0 OTHER .
No. Baths
No. Floors
No. Rooms
Rec- Room
•CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
S/8. %Z Su tr-cAU-' /�
-741-7414) 4YVkG`i..
VALUATION
9.
Source
of
Utilities
/GAS
ELECTRI
WATER
SEWER
I hereby certify that I have read and examined this applica ion 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
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 receuulating construction or the
performance of construction.
DATE // — G _ 79 SIGNATURE !/ r
DEPT.
SPECIALAPPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co: Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE /r/1-7-79- OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 040
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ AR.00
PERMIT NUMBER
� r 76( — 1 tri5
DATE /IGtJ.- 8 %979
04* *1200
*1200 N
749.48
11-08.-79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. d
1'1 �'p & 7;9• 7'4 9.5 Z
*,120020.
0
w
0