1979, 10-08 Permit: 79-5469 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION
Source
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
ELECTRIC
JOB RESS
LEGAL DESCRIPTION —SEE ATTACHED
1.
a .J�
O
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
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
ER
J
P O
Plumbing
3
Mech.
/
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
ADDRESS
Env. Health
ZIP
Required Set Backs in Feet
SEPA
Planning
North South
East West
Mobile Home
CO CTOR
P
Size of Parcel
Zone Classification
4.
AD ES
Z
Type Const.
Occupancy
Sprinklered
f
❑Yes ❑No ❑ Req'd.
DESIGNER
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
❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF
❑ OTHER
❑ BLD.
❑ PLMB. ❑ MECH: ❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
D wR�16
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 loc aw gulating construction or the
performance of construction.
Plumbing
DATE �LL—�� 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/d�e—; %FFICIAI&dL j
APPROVED FOR ISSUANCE
PERMIT NUMBER
,�? -s
DATE 1Z,,-9-7,?
03* *4200
*4200
*42000
E *000
54688
10-08-79
R 6479.
t
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10—Qd-79 546,96 *4200a