1980, 07-17 Permit: P80-7238 Pumbing 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
LOT
2.
BLOCK
/ a l`'A Aril. ie
UBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
PHONE
PARCEL NUMBER /S
ADDRESS
ZI P
Required Set Backs in Feet
North !South lEast (West
4.
5.
CONTRACT
IVO if
ADDRESS
ADDRFAc /'V%X r CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
ZIP
DWL Area I Basement Area
Split Entry
Building Area in Sq. Ft.
IGarage Area Storage
Split Level
Rancher
yVEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
❑ BLD. 'LMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE 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. Th ,ranting of a permit does not presume
to give authority to violate or cancel the provisions of any other state .� law regulating c9{lstruction or the
performance of str ction.
�� onyf�
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
7t5 t. --
NO
SPECI ' L ONDITIONS:
DATE` _/ 7-" OFFICIAL {/ zr.44r4-6
APPROVED FOR ISSUANCE
FEES COLLECTED
PERMIT NUMBER
/ So — 7238
DATE 7 - /7'F;
Single $
Building
Plumbing 60'0
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
* 30.50
* 30.50
* 3Q506
E *0.00
723.72
07 -17 -80
2 6,479,
e �r
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS ECOM A PERMIT.
(FY 8,0 721.82 *50.50ar2
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
*Coo 0