1979, 11-02 Permit P79-7232 Plumbing FixturesPLAN NUMBER
t
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
1.
J08 ADDRESSe G /O
LOT BLOCK SUBDIVISTO PARCEL NUMBER/S
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3 GLIQ. X e/4'
ADDRESS %
PHONE
ZI P
CO RACT R
' ADDRESS
c f32c3 3 - te-a.&
DESIGNER
5, ADDRESS
PHONE
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Cc -NEW ❑ ALT. ❑ AD'N. D RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Required Set Backs in Feet
North
Size of Parcel
South
East
West
Type Const.
Valuation
Occupancy
DWL Area I Basement Area
DESCRIBE WORK
8.
VALUATION
9.
GAS
of
Utilities
Source
ELECTRIC
Split Entry
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
IGarage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
SEWER
No. Rooms
Storage
Rancher
Rec. Room
Req'd.
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authoritrto violate or cancel the provisions of any other state or local law regulating construct}on or the
performance of construction.
DATE /7 SIGNATURE
107
DEPT_
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
I WsrEc-- oN F42
0f.1my pis-) 79
2-
4, 4 6th-)
DATE j1-2-71 OFFICIAL<Idinefj
Rec'd
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify
TOTAL
swig
DATE
PERMIT NUMBER
7q-7Z3Z_
VOI Q
* 37.50
* 37,50
*37.506
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723.0<
11-02-79
2 6,479,
03* *3800
* 3800 N
* 37.506
8 *0,00 0
7231g
11-02-79
g 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i1�-02-79
72'3,2z *,38,00°1:2
In PDr(`TflD
APPRf1VFf1 FlIR ISSIIANC.F