1979, 07-10 Permit 79-255 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
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/-�,n!f/yI...{�%yl�% LEGAL' DESCRIPTION — SEE ATTACHED
` /u, OC I S PARCEL NUMBER/S' �..? �/ ////
LOT BLOCK -SURD V 10 /4 '7'7�"'
JOB ADDRESS
3.
4.
3 T IvQ..1.-r
ADDRESS ZIP
CONTRACTOR PHONE
A /IA4J1
ADDR SS
DESIGNER
ADDRESS
PHONE
6I.: ,f 744`t
ZIP
PHONE
6.
CHANGE OF USE FROM
TO
ZIP
Required Set Backs in Feet
North 'South East
West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy
DWL Area I Basement Area
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
PLMB.
❑ AD'N.
E MECH:
❑ RPL.
❑ M.H.
El MVE.
❑ POOL
❑ OTHER
Split Entry
No. Baths
Split Level
Rancher
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
8.
9.
DESCRIBE WORK
VALUATION
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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 authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE _7 - q - % f SIGNATURE '2 C
DEPT.
SPECIAL APPROVALS
REC'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL CONDITW NS:
Amik/
e�C�gl'v
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing Jf
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
79-2-9s
03* *2300
*2300 to
*23006
E *0,00
25.4
07-10-79
6.479,
IINICDECTflD
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
DATE OFFICIAL
APPROVED FOR ISSUANCE
07-10-79
25,55 *23.00a�