1979, 11-13 Permit: P79-7677 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.
2.
3
LOT
BLOCK
9/e5 ild
S BD VISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
Required Set Backs in Feet
North 'South (East (West
CO NT RACTOg „t s,
4'
DCGADDRESS (,J !!(,
/
,..c.„1'617p5 �.
7t
5. ADDRESS tr jj►—
PHONE
922 "�0,7�
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
.0 a/e51,/
CHANGE OF USE FRO
6.
TYPE
7. OF
WORK
ZIP
DWL Area I Basement Area
Garage Area
Storage
TO
Split Entry
Split Level
Rancher
NEW
D 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.
-/-7;')e
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 • .nt' g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or jal :w regtJ�ruction or the
performance of const uction.
DATE /( / /7 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL • DITIONS:
DATE OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 'Y(.), `i�
PERMIT NUMBER
-7ct-7(O77
DATE
03* *44Q50
* 40.50 1,75
* 4Q506
B *0,00
767.61
11-13-79
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-1 3-7'9 76 7.7 z
*,40.50a�
INSPFCTflI