1979, 10-10 Permit: 79-5629 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
$. FEES COLLECTED
VALUATION 61,6urce GAS ELECTRIC WATER SEWER
of
9. Utilities
Single $
1 hereby certify that 1 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
performance of construction. � Plumbing
DATE j�.�11e1%J SIGNATURE ZL400''
Mech.
SPECIAL APPROVALS
DEPT_ REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
3 4.(J c/ ,
j �Zr,1i`✓
[_ Y
j lam%
DATE OFFICIAL
APPROVED FOR ISSUANCE
Plan Check
SEPA
32 -Z
Mobile Home
Other (SpA -if 1a
TOTA L $
PERM=NUMBER
DATE _/O "/G —..71
03* *35.50
*35,50
*35,50
E *000 0
5628
10-10-79
2 6479,
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
i u --10!-'7.9
S SPAC E,
'0 2! *35.50a-
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS e
LEGAL DESCRIPTION - SEE ATTACHED
L
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
O ER
PHONE
3.
DRESS
ZIP
Required Set Backs in Feet
coN ACTO
PHONE
North South
Size of Parcel
East West
Zone Classification
4.
ADDRESS?
ZIP
Type Const.
Occupancy
Sprinklered
-
1 2-0i
�i-%C;J
❑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.
TYPE
NEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
{--�/
WORK ❑ BLD. L1! PLMB. ❑ MECH: ❑ M.H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
of EXEMPTION
DESCRIBE WORK
$. FEES COLLECTED
VALUATION 61,6urce GAS ELECTRIC WATER SEWER
of
9. Utilities
Single $
1 hereby certify that 1 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
performance of construction. � Plumbing
DATE j�.�11e1%J SIGNATURE ZL400''
Mech.
SPECIAL APPROVALS
DEPT_ REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
3 4.(J c/ ,
j �Zr,1i`✓
[_ Y
j lam%
DATE OFFICIAL
APPROVED FOR ISSUANCE
Plan Check
SEPA
32 -Z
Mobile Home
Other (SpA -if 1a
TOTA L $
PERM=NUMBER
DATE _/O "/G —..71
03* *35.50
*35,50
*35,50
E *000 0
5628
10-10-79
2 6479,
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
i u --10!-'7.9
S SPAC E,
'0 2! *35.50a-