1979, 10-10 Permit: 79-5619 Plumbing FixturesPLAN NUM„c.R-
e
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
1.
2.
3.
JOB ADDRESS
L T BBLO��LOCK
LEGAL DESCRIPTION — SEE ATTACHED
UBDIVISION
PARCEL NUMBER/S
0,73t
t'�"..
ADDRESS
PHONE
ZIP
Required Set Backs in Feet
North 'South [East 'West
4.
5.
CO A yf/ 7 ,,,,f,/',,�[����/
A D R ES S��/
DESIGNER
PHONE
Size of Parcel
Zone Classification
ZIP
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
❑Yes No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH;
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/OSource GAS
of
Utilities
ELECTRIC
WATER
SEWER
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
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
performance of construction.
DATE
f�GQ
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) JUv
2-5-c"`"
1 i%JtiU
TOTAL $
PERMIT NUMBER
7 '7 -5t'/y
DATE /a—'/0-7'
03* *28.00
* 2a00
* 28006
E *0,00
561,82
10-10-79
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-10-79
5.6 1.9 *28.0,Oa1