1979, 10-19 Permit: 79-6329 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
8.
JOB ADDRESS
I r IXI-
N K,le
FEES COLLECTED
�.
0I0
. -;
ELECTRIC
LEGAL DESCRIPTION -SEE ATTACHED
SEWER
LOT
BLOCK
ISUBUIVISION
PARCEL NUMBER/S
2.
3.
OWNER
Single $
H �
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
ADDRESS
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
4�p _
Required Set Backs in Feet
performance of construction.
CONTRACTOR
DATE �C SIGNATURE_ fJ
PHONE
North South
Size of Parcel
East West
Zone Classification
SPECIAL CONDITIONS:
vs , I� yYv �..I
Plan Check
Env. Health
4'
Planning
Mobile Home
Fire Marshall
ADDRESS
Co. Engineer
Utilities
ZIP
Type Const.Occupancy
Sprinklered
-T
TOTAL $
Clearance
❑Yes ❑No ❑ Req'd.
DESIGNER
SEPA Checklist
<—
PHONE
Valuation
Building Area in Sq. Ft.
5.
DATE OFFI—�—'`i�
AP FOR ISSUANCE
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPEN
EW
ElALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
WORK El2 BLD.
,,_,/
PLMB. ❑ MECH: ❑ M.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd. I
Rec'd.
Not Req'd.
of EXEMPTION
DESCRIBE WORK
8.
I r IXI-
N K,le
FEES COLLECTED
VALUATION
Source
of
GAT
ELECTRIC
WATER
SEWER
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local aw regulating constructs nor the
t�U
performance of construction.
Plumbing
DATE �C SIGNATURE_ fJ
Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
SPECIAL CONDITIONS:
vs , I� yYv �..I
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
�Zone
TOTAL $
Clearance
WHEN MACHINE VALIDAI
SEPA Checklist
<—
THIS BECOMES A PERMIT.
101-19 �'- T9
DATE OFFI—�—'`i�
AP FOR ISSUANCE
DATE
P----7
ERMIT NUMBER
03* *30,50
*30.50
*30.50
E *0.00 C
63282
10-19-79
2 6.479.
IS SPACE,
, .9 *5 0111 5