1979, 09-26 Permit: 79-4754 Plumbing FixturesPLAN 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
35d- LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
PERMIT NUMBER
DATE
DESCRIBE WORK �,X /L�r- FEES COLLECTED
.f
OWNER
8
t
VALUATION
Source
PHONE
ELECTRIC
WATER
SEWER
of
9,
3
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
ADDRESS
type of work will be complied with whether specified herein or not. The.QraFft.ing of a permit does not presume
to give authority to violate or cancel the provisions of any other stateall aw regulatin construction or the
Plumbing
ZIP
Required Set Backs in Feet
DATE SIGNATURE _ �"` Mech.
SPECIAL APPROVALS SPECIAL! DITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
North South
East West
Planning
CONTRACTOR
Mobile Home
elOe,5
7t
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
DATE OFFICIAL
APPROVED FOR ISSUANCE
T
❑Yes ON ❑ Req'd.
DE r-4En
Building Area in Sq. Ft.
5'
ADDRESS
`PH�O_NEValuation
ZIP
DWL Area
Basement Area
Garage Area
Storage
ea
ox
/fd
r
.7��
CHANGE OF USE
FROM
TO
Split Entry
Split
Level
Rancher
6.
No. Baths No. Floors
No. Rooms Rec. Room
TYPE ,NEW
❑ ALT.
❑ AD'N.
❑ RPL.
❑ MVE.
7,
OF
1:1 BLD.
❑ PLMB.
❑ MECH:
❑ M.H.
1:11 OTHER
❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
'
WORK
of EXEMPTION
PERMIT NUMBER
DATE
DESCRIBE WORK �,X /L�r- FEES COLLECTED
.f
8
VALUATION
Source
GAS
ELECTRIC
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.QraFft.ing of a permit does not presume
to give authority to violate or cancel the provisions of any other stateall aw regulatin construction or the
Plumbing
performance f constr Ction.
DATE SIGNATURE _ �"` Mech.
SPECIAL APPROVALS SPECIAL! DITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
SEPA Checklist
0 9 Z 6 - ' 9
DATE OFFICIAL
APPROVED FOR ISSUANCE
03* *40.50
*4a50 �
*40,50
E *000 n
475,32
09-26-79
2 6,479,
i SPACE,
477.4 *40,50,,c-'