1979, 12-12 Permit: 79-8984 Mechanical FixturesPLAN NUMBER ' Y
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 H LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK 1SUBDIVI51UN I PARCEL NUMBER/S
OWNER
3. -2-
Amu!
ADDRESS
F— 11 o
COONNTRAC
/�-/
/-1/
4' ADDRESS
DESI NER
5. ADDRESS
R
CHANGE OF USE FROM
6.
'PHONE
-
ZIP
LG
PHONE
ZIP,
9
PHONE
ZIP
TYPE ANEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF WORK L1BLD. ❑ PLMB. MECH: ❑ M.H. [I POOL El OTHER
F(equired Set Backs In reet
North South
East West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
I
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
I Recd.
Not Re(
of EXEMPTION
dLPERMIT NUM$
_�q-ZqSq
DATE
04* *7.00
7.00
*7,000
E X0.00
898.32
12-12-79
6479.
8 L I R! IJ i E �— K 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 $ �• bC�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. „ ^ n 4
nATE /-Y/Z/ / /OFFICaVC4,-,��IALJ L —1 2 �� -
��-APPROVED FOR ISSUANCE
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