1979, 10-09 Permit: G79-5536 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 A DRESS
, 2AYA LEGAL DESCRIPTION — SEE ATTACHED
OWNER
1 'a f v C+i
VALUATION Source GAS ELECTRIC WATER SEWER
PHONE
of
9. Utilities
Single $
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
Building
C411 L
to give authority to violate or cancel the provisions of any other state or I al law regulating construction or the
3.
performance of construction.
Plumbing
U�
DATE (�"� SIGNATURE_
-+
Mech.
ADDRESS
DEPT. REQ'D. REC'D.
Plan Check
ZIP
Required Set Backs in Feet
.
Planning
Fire Marshall
Mobile Home
North South
East West
CONTRACTOR
PHONE
Size of Parcel
zone Classification
1
C'
�7
4'
-T
ADDRESS (
'-:>
ZIP .
Type Const.
Occupancy
Sprinklered
iv C'
(�'
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6. mil..
C
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑NEW ALT.
❑ AD'N.
1:1 RPL.
E) MVE.
], OF
rPLMB.
El OTHER
WORK ❑ BLD.
�ECH:
❑ M.H.
❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WO K
8• S
1 'a f v C+i
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
Single $
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
Building
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 I al law regulating construction or the
performance of construction.
Plumbing
U�
DATE (�"� SIGNATURE_
-+
Mech.
SPECIAL APPROVALS SPECIAL CONDITI NS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
DATE�v OFFIC w
TOTAL $
PERMIT NUMBER
0 (9- 1 -71 - 5 7,22 6 -
DATE 1?_1 2-7 7
04 *9.00
*9.00 In
*9006
E *Q00 8
55351
10-09-79
1 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS fECOTIF A �TMIT. 51 r 3, L 5