1979, 12-07 Permit: P79-8795 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 ADDRESS
9tos Or -
1. L T
2.
3.
LEGAL DESCRIPTION — SEE ATTACHED
LOCK
SUBDIVISION
OWNER
-_ alt rite p s Y
ADDRESS
ilo 24 PC
CONTR CTOR
4. ,,% B ' E --"—AI Fe4 J2Y I T eS [C'
AD/ R so J
/-
PHONE
91y—
ZI
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East 'West
PI1 O N
�611-z
Size of Parcel 1 Zone Classification
zip�����
Type Const.
Occupancy
Sprinklered
DYes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
M NEW
❑ BLD.
,❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
IQ�PLMB. ❑ MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
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 do- " of pr:sume
to give authority to violate or cancel the provisions of any other state or local,<w regu•ting c. structi.� the
performance ofconstruction.
DATE ! 7/6% 7 SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
t
DATE/2-7' 7 l OFFICIAL
SC"
30, X/
ADDDl11/Cl% Cr1D 1001 IA MrOr
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
3C , o0
Other (Specify) f/
TOTAL $
PERMIT NtJMBE�
DATE / 4? __77
03* *33,00
*3300
*33006
E *000
879,4
12-07-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12!-0"7'.1.-'79' 879,52 *33.00a -F2