1979, 11-05 Permit: 79-7286 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK r
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 WPIES
8.
JOB ADDRESS
7/9
Source
LEGAL DESCRIPTION - SEE ATTACHED
1
WATER
SEWE]thhis
9
ofi
Utilities
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governiBuilding
type of work will be complied with whether specified herein or not. The ntin f a permit does not pto
tionPlumbing
OWNER
PHONE
performance of constr ction.
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS
SPECIA C NDITIONS:
3.
Plan Check
ZIP
Required Set Backs in Feet
ADDRESS
SEPA
Planning
North South East West
Mobile Home
CONTRAC R
PHONE
Q
Size of Parcel
Zone Classification
Co. Engineer
�ny
4'
ZIP
Type Const. OccupancySprinklered
ADDRESS
D
Dyes❑No ❑ Req'd.
R
P��DNE
Valuation Building Area in Sq. Ft.
R&9�
5.
ADDRESS
ZIP
DWL Area Basement Area Garage Area Storage
994,
CHANGE OF USE FROM TO
Split Entry Split Level Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW
❑ALT. El AD'N. ❑ RPL.
❑ MVE.
7,
OF
❑ BLD.
❑ PLMB. ❑ MECH: ❑ M.H.
❑OTHER
❑ POOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK r
FEES COLLECTED
8.
VALUATION
Source
GAS
ELECTRIC
WATER
SEWE]thhis
9
ofi
Utilities
I
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions in
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governiBuilding
type of work will be complied with whether specified herein or not. The ntin f a permit does not pto
tionPlumbing
give authority to violate or cancel the provisions of any other state or c I I regu onstr
performance of constr ction.
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS
SPECIA C NDITIONS:
Plan Check
DEPT. REQ'D. REC'D.
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
DATE
PERMIT NUMBER
(VJ — _7 Z
03* *33.00
*33.00 U
72852
1 1 -05-79
6479.
Utilities TOTAL $ :!!!!±�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
DATE
_ OFFICIAL
APPROVED FOR ISSUANCE
11 05-7' ?z3,b�
L