1979, 10-10 Permit: 79-5627 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
4 � LEGAL DESCRIPTION — SEE ATTACHED
OT LOCK UBDIV SIGN I PARCEL NUMBER/S
TYPE fa NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. LMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 ' 3 , `.4j.) FEES COLLECTED
VALUATIONource
of GAS ELECTRIC WATER SEWER
Q, f7Utilities
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 Plumbing -3.0
performance of construction.
DATE l%��1�/�/9 SIGNATURE'�^� t✓�`� Mech.
DEPT.
O ER
Env. Health
PHONE
Planning
Fire Marshall
3
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DRESS
ZIP
Required Set Backs in Feet
North
South
East West
CO TRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
t.
Type Consccupancy
O
Sprinklered
/-'?2 O
��i/
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL 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 fa NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. LMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8 ' 3 , `.4j.) FEES COLLECTED
VALUATIONource
of GAS ELECTRIC WATER SEWER
Q, f7Utilities
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 Plumbing -3.0
performance of construction.
DATE l%��1�/�/9 SIGNATURE'�^� t✓�`� Mech.
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
71
SPECIAL CONDITIONS:
3 u"
Gc1
DATE OFFICIAL
APPROVED FOR ISSUANCE
Plan Check
SEPA
Mobile Home
PERMIT NUMBER
DATE /U `/'�%V
03* *35.50
*35.50
tn-
3
E *0.00 00
56262
10-10-79
$ 6479,
Other (Specify) .141-0
TOTAL $�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-10-79 56275
*35.5,0°l