1979, 08-17 Permit: 79-2386 Sprinkler SystemPLAN 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
1.
2.
3
JOB ADDR
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LEGAL DESCRIPTION — SEE ATTACHED
OWNEF�
ADDRE
CONT CTOR
4.
ADDRESS
PHONE
qac-�o:
ZI P
ggrk\ D
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East (West
Size of Parcel Zone Classification
ZIP
gC\o\L
Type Const.
DESIGNE
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
TO
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Split Entry
No. Baths
Split Level
Storage
Rancher
No. Floors No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE_WORK
PLUATION
Source
of
Utilities
GA
v3st\o
ELECTRIC
WA ,ER
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 1) "\1b`CS\
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
FEES COLLECTED
Single S
Building
Plumbing
Mech.
Plan Check
^A SEPA
7 OFFICI `�7
APPRO FOR ISSUANCE
Mobile Home
Other (Specify)
TOTAL $ S.St7
PERMIT NUMBER
-7, -2278
DATE
04* *550
*550
*5.508
A *Q00 8
23852
08-17-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-17-79
238,62
*5,50°F-