1979, 11-01 Permit: 79-7109 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — EWILD614G CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
ADDRESS ZIP Required Set Backs in Feet
7 North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ADDRESS ZIIPP' Type Const. Occupancy Sprinklered
IOYes [-]No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Ar7 Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW El ALT. ElAD'N. El RPL. ElMVE.
7, OF ❑ OTHER
WORK
❑ BLD. NrPLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
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
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
Co. Engineer Other (Specify)
Utilities
TOTAL $,�
Zone Clearance
WHEN MACHINE VALIDATED IN -1
SEPA Checklist f THIS BECOMES
I A PERMIT.
1l
DATE OFF L
. t 0 1— 7 9
AP FOR ISSUANCE
PERMIT NUMBER
03* *35.50
*35.50
*35,50
E *000 n
71 0.92
X11-01-79
2 6479,
SPACE,
1 1,03 55,5 � a
O
I
U
— w
2
z