1979, 11-21 Permit: 79-8236 Mechanical FixturesPLAN NUMBER APPLICATION/ PERMITPERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT I*% '79 -
NORTH
7 1NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
VALUATION Source
of
9 utilities
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
WATER
JOB ADDRESS
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
LEGAL DESCRIPTION - SEE ATTACHED
1.t
(�LS i) EZ .
I
%YN
Plumbing
performance of construction.
LOT LOCK
SUBDIVISION
SPECIAL APPROVALS SPECIAL CONDITIONS:
PARCEL NUMBER/S
2.
Env. Health
SEPA
Planning
OWNER
Mobile Home
Fire Marshall
PHONE
- & D (/,'
Other (Specify)
3.
ADDRESS
T'
Utilities r� ^^
$�
ZIPq,�tt-,�
Required Set Backs in Feet
Zone Clearance
10106
1
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
p a
North South
East West
DATE OFFICIAL
,
CONTRACTOR
APPROVED FOR ISSUANCE
PHONE
Size of Parcel
Zone Classification
I D4,
- ��
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
'
99-�9
❑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.
Baths
No. Floors
No. Rooms
Rec. Room
TYPENo.
NEW
❑ ALT.
❑ AD -N. ❑ RPL.
❑ MVE.
7,
.
OF
ElBLD.
11 PLMB.
X MECH: El M.H.
❑OTHER
❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8.
WSTAU� AIR
,/OR
k
VALUATION Source
of
9 utilities
GAS
9 ELECTRIC
WATER
SEWER
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.
DATE SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. EQ'D. REC'D. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities r� ^^
$�
TOTAL
Zone Clearance
IN TH
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
SEPA Checklist
DATE OFFICIAL
APPROVED FOR ISSUANCE
04* *7,00
k 7, on v
*7,006
E *0,00 CS
823.5
11-21-79
6479,
bl-AL; t,