1979, 07-23 Permit: 79-900 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
1.
BLOCK SUBDIVISION PARCEL NUMBER/S
OWNER.... F � PHONE
3. "6
ADDRESS ZIP Required Set Backs in Feet
North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
./, � -�, •rte � .�
4'ADDRESS ZIP Type Const. Occupancy Sprinklered
n n
❑Yes No Req'tl.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE GYa` ��EW ❑ ALT. ElAD'N. 1:1 RPL. ElMVE.
7, OF ��� ❑OTHER
WORK 1:1BLD. P-RLMB. ElMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIHE WORK
FEES COLLECTED
8. ff'`'' e�
VALUATION S urce GAS ELECTRIC WATER SEWER
of
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 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
1 ' Plumbing
performance of construction. �, "IN
DATE r¢�`J t l) SIGNATURE �7 P Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.Y�jl��y/_ ►/I ",( .n Plan Check
U
Env. Health I ''I�"'- 4I I
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities a
DATE
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN TH
� PERMIT
SEPA Checklist
DATE�z ICIA
A PRO FOR ISSUANCE
THIS BECOMES A
0.7-23-79
PERMIT NUMBER
03* *30.50
*3050
*30506)
A *0.00 0
89.92
07-23-79
;? 6,479,
PACE,
90.0c *30,500,-
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