1979, 11-19 Permit: 79-8045 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
LRMIT NUMBER
r`
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
V
11-12-7V
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
03* *3550
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
* 3 5 5 0
�. �� '\%�
*3550'
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
Ptz,
E *0,00
PHONE
O NE a
+�
3.
8 04.4
A D S
ZIP
Required Set Backs in Feet
c>
/6North
South East West1-19-79
CONTRACTOR /
PHONE
Size of Parcel
Zone Classification
-ivy~c
/ZIP
- 6479.
4.
ADDRESS /] G
�?
Type Const.
Occupancy
Sprinklered
❑No ❑
ri� /, A
'i )
(ate
❑Yes Req'd.
r
DSIGNER
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 El NEW ❑ ALT. ElAD'N. 1:1 RPL. ElMVE.
7, OF ❑OTHER
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑ POOL
CERTIFICATE Req'd.
I Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE W9RK ,- - FEES COLLECTED
8.
VALUATION Source GASk, ELIECTRIC 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 local law regulating construction or the -�
Plumbing
performance of construction.
C
DATE L/ "/� - t SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CON ITI S:
DEPT_ REQ'D. REC'D. Plan Check
Env. Health
SEPA
o0
Planning
—
v
wa.
Mobile Home
N
z
Fire Marshall
—
Co. Engineer Other (Specify)
Utilities
$
TOTAL
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklistv- Y THIS BECOMES A PERMIT.
-= i J/ ,l �''�
d D J
8 0 4 5 2 * 3 5.'5 0 a I
DATE 0FFICIAi /f� -X ''✓ 01r�C2 x.
APPROVED FOR ISSUANCE