1979, 07-30 Permit: 79-1222 Plumbing FixturesPLAN NUMBER
1
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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
Plumbing
performance of construction. A
DATE ` j3 --11 SIGNATURE ��r Y elm Mech.
V SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
eb L--ov � Plan Check
f/�� �✓'Y I SEPA
Mobile Home
Other (Specify)
fl4TF// �"/// (lFFlf`I01
PERMIT NUMBER
y ��2 J
DATE
0 3 1 4. 5 0
*14.50
* 1 4.5016
A *0.00
1221
07-30-79
;2 6479,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS ffO(IFf AP7MIT. i 2 ) 2 z
*1450°I_
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1
JOB ADDRESS
wGK
LEGAL DESCRIPTION —SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
I
OWNER
PHONE
3.
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
O E ��
Size of Parcel
Zone Classification
4'
AD ES
/a�VIM�
!�]d
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ 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 ❑ AL . ❑ AD'N.
❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
%,
OF
El OTHER
WORK ❑BLD. PLMB. ❑ MECH:
ElM.H. ❑POOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd
of EXEMPTION
s.
DE
CRI E WORKI
OINN6`1X12
11�.
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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
Plumbing
performance of construction. A
DATE ` j3 --11 SIGNATURE ��r Y elm Mech.
V SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
eb L--ov � Plan Check
f/�� �✓'Y I SEPA
Mobile Home
Other (Specify)
fl4TF// �"/// (lFFlf`I01
PERMIT NUMBER
y ��2 J
DATE
0 3 1 4. 5 0
*14.50
* 1 4.5016
A *0.00
1221
07-30-79
;2 6479,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS ffO(IFf AP7MIT. i 2 ) 2 z
*1450°I_