1979, 07-06 Permit App: 79-142 Plumbing FixturesPLAN NUMOM APPLICATION/ PERMIT
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PERMITMBER
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SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
£ IS 3 3i
LEGAL DESCRIPTION - SEE ATTACHED
1.
LOT
BLOCK
SUBDIVI IO /
ko A
PARCEL NUMBER/S
2 20�2�
S o
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OWNER
PHONE
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92
03* *3300
3.�/-3sc,z
*3300
ADD RE SZIP
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Required Set Backs in Feet
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North South East West
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CONTRACTOR ^
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PHONE
Size of Parcel
Zone Classification
07-06-79
4'ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
[--]yes ❑No ❑ Req'd.
6479,
gCiR-
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.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑NEW El ALT. 1-1AD'N. El RPL. ❑ MVE.
7. OF OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
1:1 BLD. ❑ PLMB. E)MECH: 1-1M.H. ❑ POOL
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
/2 ��
$ ����
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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 33.
performance of construction. Plumbing oo
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DATE 9—&SIGNATURE _ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Thcr�
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A PERMIT.
DATE OFFICIAL - 7 �jl '7 9
14.2 2 *'3 3, 0,0 a FI
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DATE
REMARKS
RECORD OF INSPECTIONS
Final Inspection
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INSPECTED BY
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