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1980, 07-21 Permit: P80-7420 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 1. LOT 2. BLOCK / ; ©t J, A r rc SUBDIVISION LEGAL DESCRIPTION - SEE ATTACHED 3. OWNER PHONE PARCEL NUMBER /S ADDRESS ZIP Required Set Backs in Feet North (South [East (West CONTRAC OR Alen ( 191 4. A pDRES 27)/ 1 5;y Y< {" '' .ter r. 5. AfdgF SS ��x //?c2 / CHANGE OF USE FROM 6. TYPE 7, OF WORK PHONE Size of Parcel I Zone Classification ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. PHONE ZIP y : /0 Valuation (Building Area in Sq. Ft. DWL Area I Basement Area Garage Area I Storage TO Split Entry Split Level Rancher NEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE. ❑ OTHER ❑ BLD. IPLMB. ❑ MECH: ❑ M.H. ❑ POOL No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRI BE WORK 8. VALUATION 9. 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 g of a permit does not presume to give authority to violate or cancel the provisions of any other state o regula con uction or the performance of /onstruu do DATE 7l 6l r � SIGNATURE DEPT. Env. Health Planning SPECIAL APPROVALS REQ'D. REC'D. Fire Marshal l Co. Engineer Utilities Zone Cleara nce SEPA Checklist SPECIAL ITIONS: DATE FEES COLLECTED Single $ Building Plumbing / j F Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ / g_619F DATE PERMIT NUMBEFj, 03* *18.00 *18.00 * 1 8.006 E *0.00 741.92 07 -21 -80 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. `07- ,21L8T1 742.05 *18,00a� DATE REMARKS RECORD OF INSPECTIONS Final Inspection INSPECTED BY