1979, 08-31 Permit: 79-3263 PipingPLAN NUMBER APPLICATHMAPERMIT
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. r In c- nnn A 1010-7 in� .
Iq
CHANGE OF USE FROM ITO
6.
TYPE ❑ NEW
7, OF
WORK BLD.
DESCRIBE WORK
8. C
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
❑ PLMB. ❑ MECH: ❑ M.H. X POOL
C0-nyk0& or 0�
equired Set Backs in
Size of Parcel
LOT
BLOCK
SUB[
2.
Occupancy
Sprinklered
OWNER
3.
m rS . C�c
ADDRESS
DWL Area
E. /coc
Garage Area
CONTRACTOR
4.
ADDRESS
Split Level
Rancher
DESIGNER
5.
ADDRESS
Iq
CHANGE OF USE FROM ITO
6.
TYPE ❑ NEW
7, OF
WORK BLD.
DESCRIBE WORK
8. C
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
❑ PLMB. ❑ MECH: ❑ M.H. X POOL
C0-nyk0& or 0�
equired Set Backs in
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Recd.
Not Re
of EXEMPTION
FEES COLLECTED
/ 5 I7c EYi7���
VAL ATI 1 d Sour a uHb n�tvi r<ii WATE SEWER
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 6'30^7! SIGNATURE=,4:&�/ Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
14
DATE// ! OFFICI R
APPRO OR ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTA L $
7/ PERMIT NUMBER
DATE 9✓�
04* *600
*600 N
*60006
A *000
3262
08-31-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS ffONT A REMIT. 2 6 3 z
*6.00°x_
�j