1979, 10-10 Permit: 79-5625 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
VALUATION
9,
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
ELECTRIC
JOB ADDRESS
SEWER
Single $
LEGAL DESCRIPTION - SEE ATTACHED
OT
BLOCK
SUBDIVISION
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
PARCEL NUMBER/S
2.
Plumbing
DATE SIGNATURE l2
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. r REQ'D. RECD.
Plan Check
OVUR
Planning
PHONE
3
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
C..CJ
�ifOel�tet.�
ESSlop
�— Ct
TOTAL $, Is—
Zone Clearance
C Cit/ v
ZIP
Required Set Backs in Feet
WHEN MACHINE VALIDATE
SEPA Checklist ��
THIS BECOMES A PERMIT.
% ':`i _ .'� DATE OFFICIAL
North South
East West
CON ACTOR
PHONE
Size of Parcel
Zone Classification
4.
-,ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
FJ.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE EW E] ALT.
❑ AD'N. 1:1 RPL.
I—]MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
❑ BLD. Lr'fLMB.
❑ MECH: ❑ M. H.
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
FEES COLLECTED
8
VALUATION
9,
Sour&V
of
Utilities
I GAS
ELECTRIC
WATER
SEWER
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
performance of construction.
Plumbing
DATE SIGNATURE l2
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. r REQ'D. RECD.
Plan Check
Env. Health —3
Planning
SEPA
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
C..CJ
�ifOel�tet.�
Utilities
�— Ct
TOTAL $, Is—
Zone Clearance
C Cit/ v
WHEN MACHINE VALIDATE
SEPA Checklist ��
THIS BECOMES A PERMIT.
% ':`i _ .'� DATE OFFICIAL
APPROVED FOR ISSUANCE
PERMIT NUMBER
DATE /2
03* *35.50
*3550
*3550
E *000
5624
10-10-79
;F 6479,
O
1 --
CD
— w
cZ
Z