1979, 09-13 Permit: 79-3909 Plumbing FixturePLAN 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- * LEGAL DESCRIPTION — SEE ATTACHED
LOT LOCK SUBDIVISION PARCEL NUMBER/S
QWNER�
3 ADDRESS
E.
CONTRACTOR
4. ADDRESS
Z—, 16[6 6
DESIGNER
5. ADDRESS
0
CHANGE OF USE FROM ITO
6.
PHONE
ZIP
rPHONE�
74
ZIP
9900
PHONE
ZIP
I yrt ❑ NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
7 OF WORK ❑ BLD. XP LMB. MECH: L1M.H. El POOL
11 OTHER
DESCRIBE WORK n
8. �,`c J %/
equired Set Backs in Feet
Source
Orth South
East West
ize of Parcel
Zone Classification
9.
Type Const.
Occupancy
Sprinklered
I
Dyes ❑No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
DWL Area
Basement Area
Garage Area
Storage
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Split Entry
Split Level
Rancher
DATE 7 �` / SIGNATUR
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
No. Baths
No. Floors
No. !oopmsRec.
Room
SEPA
Planning
CERTIFICATE
Reqd.'d.
Not Req'd.
of EXEMPTION
FEES COLLECTED
VALUATION
Source
GAS V
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
1 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 local law regulating construction or the
performance of construction.
Plumbing
�
DATE 7 �` / SIGNATUR
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE OFFICI �ISSUANCE
APP DFOR
Mobile Home
Other (Specify)
TOTAL $�)
PERMIT NUMBER
7 39 0
DATE 9—/-1—_7 9
04* *7.00
*7.00
to -
7.
A *0.00 0
390,8
09-13-79
R 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THISM S P�jRMIT.r
/ —'� I j I IJ i C3
0
*7. 0 no_'
Ua.F-