1979, 11-05 Permit: 79-7288 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
VALUATION
LEGAL DESCRiPTION — SEE ATTACHED
GAS
ELECTRIC
WATER
LOT
BLOCK
of
Utilities
PARCEL NUMBER/S
2.
I
ISUBDIVISION
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
OWNER
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
PHONE
type of work will be complied with whether specified herein or not. The grant' g of a permit does not presume
3.
to give authority to violate or cancel the provisions of any other state or al w regula ' con uction or the
,L
Plumbing
performance f co 's't]ruction.
ADDRESS
DATE 111-Z�/ SIGNATURE Mech.
ZIP
Required Set Backs in Feet
DEPT. REQ'D. REC'D. { Plan Check
North South
East West
CO NTRACTU % `'
PHjONEE L�
Size of Parcel
Zone Classification
Co. Engineer Other (Specify)
Utilities
4'
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
(G✓ —
❑Yes ❑No ❑ Req'd.
�6TRfd�R-
.t^
PHONE_
Valuation
Building Area in Sq. Ft.
5'
cZJl�ep'?^
ADDRE ` ^ ,
f
C/y/C,L
_��
DWArea
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 X NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER Not Req'd.
WORK ElBLD. 1:1PLMB. ❑ MECH: ElM.H. ❑ POOL CERTIFICATE Req'd. I Recd.
of EXEMPTION
DESCRIBE WORK
P PERMIT NUMBER
--7 �4�b
DATE
03* *33.00
*33.00
72&7
11-05-79
9 6479.
8. / ,;� /— "X -/ a rYi '----> FEES COLLECTED
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
Utilities
Single $
I 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 grant' g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or al w regula ' con uction or the
,L
Plumbing
performance f co 's't]ruction.
DATE 111-Z�/ SIGNATURE Mech.
SPECIAL APPROVALS SPECT C NDITIDNS:
DEPT. REQ'D. REC'D. { Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
C 0 0
�o,u
DATE OFFICIAL 1 i�d5-7;'
APPROVED FOR ISSUANCE
*,3 3.0 0 a
- W