1979, 12-28 Permit: 79-9590 Mechanical FixturesPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — WILDING CODES DEPARTMENT � M � � c
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
DESCRIBE WORK
8. jA)s—rALL-
FEES COLLECTED
VALUATION
Source
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
VVH I tK
JOB ADDRESS
9,
of
Utilities
LEGAL DESCRIPTION — SEE ATTACHED
1
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
LOT
BLOCK
SUBDIVISION
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
PARCEL NUMBER/S
2.
DATE SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
OWNER
Env. Health
PHONE
SEPA
ISRIACE
)4 1 i A HL]7North
Mobile Home
3
ADDRESS
ZIPRequired
Set Backs in Feet
y ,
G%2
South East West
CO TRAC OR
PHONESize
of Parcel Zone Classification
/J
—4'ADDRESS
ZIPType
Const.
Occupancy
Sprinklered
4��
❑Yes ❑No ElReq'd.
DES GNER
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.
Baths
No. Floors
No. Rooms
Rec. Room
TYPENo.
A NEW
❑ALT.
❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF
❑ BLD.
❑ PLMB.
XLMECH: ❑ M.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
8. jA)s—rALL-
FEES COLLECTED
VALUATION
Source
uH5
tLti i Kii
VVH I tK
JCvvtK
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 SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE ," OFFICIAL Au
Q^�
APPROVED FOR ISSUANCE
TOTAL $ 7DG
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
04* *7,00
#7.00
*7.00
E *0.0c
958.92
12-28-79
6,479,
THIS SPACE,
6G
J -u_ *7.a�