1979, 09-17 Permit: 79-4141 Mechanical 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 ADDRESS
1. +5-10
e.
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBOI (SIGN
WNER l�
3. aH/U ern �J
PHONE
SSS"-- 97,39
PARCEL NUMBER/S
ADDRESS
ZIP
9
Required Set Backs in Feet
North (South East
'West
ON RACTOR
�l
A SSU L. 'tom T4
4.
�ia11DA,ur+.
ADDRESS
DESIGNER
5.
PHONE
PHONE
/6
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZI P
DWL Area Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
X NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.� A-5 13(P o
VALUATION
9.
�KlSir��i vfJt't 14Ea r �,
Source
of
Utilities
GAS
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 loyal law regulating cotstruction or the
performance of construction.
DATE 9-/ 7l SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
OFFICIA
APPROV Y OR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
.c'
p
TOTAL $
PERMIT NUMBER
7E - 414-(
DATE
*600
*600 N
*6,006
B *Q00 0
414,0g
09-17-79
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-.17-79
41415
*6.00°F-
U
W