1979, 11-19 Permit: 79-8047 Piping' 1PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES -
OB ADDRESS
L
2.
BLOC
E . 7102
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNE
3
PHONE
ADDRESS
ZIP
Required Set Backs in Fee
North
South
East (West
CONI/�NVr lou e i u.l u �C,/
ADDRiSS
�. l3a-I /Qs -h
�PHONE
5&/00
Zip
9 o/
Size of Parcel
Zone Classification
Type Con
Occupancy Sprinklered
❑ves Ohio ❑ Req'd
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
SPllt Entry
Split Level
Rancher
TYPE
0 NEW
7. OF
WORK BLD.
❑ ALT.
❑ PLMB
❑ AD N.
O MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
59 OTHER
No. Bath
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd
Not Req'd.
8.
9.
DESCRIBE WORK
eO1J
cfl p pk
VALUATION Source GAS
o�Utilities g
of Jt
ELECTRIC
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 correc . 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 regulating constructiongr the
performance of construction.
DATE -nazi / j 61 x'109 SIGNATURE 1� 1
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS
71 oP
/f
t PiFit-
//-79-79 /n J/��
DATE OFFICIAL f\.I.Y. �i1(iW`r '
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
/n 00
DATE
PERMIT NUMBER
79-8'o/747
7/-/9-79
04*
E
90462 -
1:1a-19-79
3 6479.
* 1200
* 1200 N
* 120.08
*Q00 8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM S A PERMIT.
_,1. '_.1,9,
8047= *,1200 e