1979, 11-19 Permit 79-8092 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 A RESS
0T 1 BLOCK
SUBDIVISION
3
OWNEK'
dz'
ADDRFGS
CON RACTO
4.
ADDRESS
/l , 0 7 D'1
-12
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
i, 2r1 "Ye
ZIP
P ONE Size of Parcel
PHONE
TYPE
7. OF
WORK
8.
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. PLMB. ❑ MECH: ❑ M.H. ❑ POOL
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
0 OTHER
Split Entry
No. Baths
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South East West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Garage Area Storage
Split Level Ranche
No. Floors No. Rooms
CERTIFICATE
of EXEMPTION
Rec. Room
Req'd. Rec'd.
ELECTRIC
WATER
SEWER
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 authority to violate or cancel the provisions of any other state or local la regu •ryg construn c the
performance of construction.
DATE
SIGNATURC-N -'•-
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
//- /9-79
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing >` 7$0
Plan Check
SEPA
Mobile Home
li/J
Other.� (Specify) -f✓
TOTAL $`.
PERMIT NUMBER
79 -Fe9 "'
DATE /fit
03* *30.50
*3050 17)
*3Q506
E *Q00 8
809.1R
11-19`-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE OFFICIAL / V
APPROVED FOR ISSUANCE
11-'19-_•7.9 809,2z *,30,50,2.