1979, 12-04 Permit: P79-8668 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
1. /k//2 EA,5f /7
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
4.
OWNER
ADDRESS
E, /17;to 31'/au.),e4t)
CONTRACTOR
/A- Pte); ZnYc .
ADDRESS , / I
/12Z A/0a54-0
PHONE
1'0- To 7g
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East !West
PHONE
i/ 6 357
ZIP
91Zo7
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
Elves ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
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 ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑
BLD. PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8. DESCRIBE WOR�j x 6 /
VALUATION
9.
Sdurce
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 local law regulating construction or the
performance of construction.
DATE
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE//j/i"7F OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3,675-0
DATE
PERMIT NUMBER
-1c
/2- 3- 79
03* *3550
*3550
*35506
E *000
86678
12-04-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
866,82 *35.50