1979, 11-16 Permit: 79-7976 Plumbing FixturesPLAN NUMBER 41 APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS.
� cA1 � ��, �)� LEGAL DESCRIPTION -SEE ATTACHED
118
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
ADDRESS ZIP Required Set Backs in Feet
North South East West
CONTRAC OJ ,6P--
�'Gk� M231�tJ G
4' ADDRESS C �^
DESIGNER
5. ADDRESS
's} ye
CHANGE OF USE FROM ITO
6.
PHONE
Size of Parcel
Zone Classification
tg?_`i/
7, OF El OTHER
❑ BLD. �PLMB. ❑ MECH: ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
ZIP`
Type Const.
Occupancy
Sprinklered
;r9%M,7
I
❑Yes [-]No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
Source
GAS
ELECTRIC
WATER
ZIP
DWL Area
Basement Area
Garage Area
Storage
9,
Utilities
Split Entry
Split Level
Rancher
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
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ANEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El OTHER
❑ BLD. �PLMB. ❑ MECH: ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
FEES COLLECTED
$ R
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 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
- 50
performance of construction
Plumbing 110,
/
16-' d ��
DATES//—
SIGNATURES, <'/9
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
PER-MiT NUA,1BER
27 7�--
03* *3050
*30,50
*3050
E 0. Or)
797,5-m
1 1 —16-79
2 6.479,
TOTAL $
r WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9i,
DATE O CIA o
ED FN ISSUANCE
r
4
*,50.50
i_