1979, 11-15 Permit: 79-7941 Plumbing FixturesPLAN 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
JOB A D ESS
1. o %vim LEGAL DESCRIPTION — SEE ATTACHED
ff
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
FEES COLLECTED
8. U
VALUATION
Source
GAS
ELECTRIC
PHONE
SEWER
9.
of
Utilities
Single $
ADDRESS
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
ZIP_/(
Required Set Backs in Feet
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
� /�
North South
East West
CONTRj`\qTOR
to give authority to violate or cancel the provisions of any other state or cal law regu ting construction or the
PHONE
Size of Parcel
Zone Classification
4' (
ADDRE,$S' ^
DATE/,/—�� SIGNATURE'IL ��--
_ „�
Type Const.
Occupancy
kl❑
❑Yes ❑No Req'd.
DESIIIffVVGII N,JER
DEPT. REQ'D. RECD.
Plan Check
PHONE
Valuation
Building Area in Sq. Ft.
5.
SEPA
❑
C
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
Mobile Home
Fire Marshall
Co. Engineer
CHANGE OF USE FROM
TO
Utilities
r�
Split Entry
Split Level
Rancher
6.
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist 7
THIS BECOMES A PERMIT.
No. Baths
No. Floors
No. Rooms
Rec. Room
Ell"
,�/
TYPE LrJ NEW El ALT.
El AD'N.
1:1 RPL.
El MVE.
7, OFR /
OTHER
Elt
--PL
11 BLD. LVJ PLMB.
ElMECH:
❑ M. H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
No Req'd.
WORK
of EXEMPTION
PERMIT NUMBER
L r712 .T �f
DATE
02* *1250
* 1 250 N
* 1 2.50c
E *Q00
794,0.9
11-15-79
z 6.479,
V
DESCRIBE wo K
FEES COLLECTED
8. U
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 f a p rmit does not presume
to give authority to violate or cancel the provisions of any other state or cal law regu ting construction or the
Plumbing l�
performance of construction.
DATE/,/—�� SIGNATURE'IL ��--
Mech.
SPECIAL APPROVALS SPECIAL c0 ITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
❑
C
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
r�
TOTAL $�
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist 7
THIS BECOMES A PERMIT.
�.� - DATE DFFICIAI / b _ 1�a,
.' 9
7 9 41 z
*.I 2 5 0 a