1979, 09-27 Permit: G79-4841 Mechanical FixturePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARL 'TO MAKE 4 COPIES
JOB ADDRESS ( „„ ^�I /�
7co
LEGAL DESCRIPTION -SEE ATTACHED
ctt_,&_�
to give authority to violate or cancel the provisions of any other state or local law regulating construccin or the
LOT
BLOCK
UBDIVISION
. Mech.
PARCEL NUMBER/S
2.
I
Env. Health
OWNER:E�a,j
SEPA
PHONE
Planning
Ce
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
3.
Utilities
TOTAL $
ADDRESS
Zone Clearance
ZIP
Required Set Backs in Feet
IN THIS SPACE,
SEPA Checklist THIS BECOMES APERMIT.
North South
East West
CO RCT
k 1 l�-
'
PHONE
Size of Parcel
Zone Classification
4.
AD ESSZIP
,2312-;J
Type Const.
Occupancy
Sprinklered
[]Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHAN E OF USE FROM
TO
Q3
Split Entry
Split Level
Rancher
6.
TYPE ❑ NEW ❑ ALT. 1-1AD'N.
WZPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ OTHER
El BLD. ❑ PLMB. �ECH:
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCR BEF WORK
PERMIT NUMBER
$ �79 - 8 �
DATE 2--1.7' 7'%
04* *1200
*1200 N
*120011
E *0.00 �
4840f
09-27-79
–4 6479
8 YQ Y FEES COLLECTED
VALUATION Source GA ECTRIC WATERSEWER
of
utilities Single $
01�49,
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 construccin or the
performanc of c nstruction. Plumbing
DATE /�" 1 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
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES APERMIT.
0 " 2 ` % 19
`/� f Q u `/� j
z * 12 0 0; a°
DATE OFFICIAL
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