1980, 10-02 Permit: P80B-1302 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 3 COPIES
JOB ADDRESS
LOT
BLOCK
3.
OWNER
S UBDIVISION
ADDRESS
4.
6.
CO NTRArrTjO7
ADDr --
PHONE
ZIP
PHONE
222 —4/elq
ZIP
•
X' lot 2 T
TO
CHANGE OF USE FROM
TYPE
7. OF
WORK
PHONE
ZIP
Cae'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. PLPLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
East 'West
Occupancy
Valuation
Main Floor
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors Garage Area Storage
Area of Decks
Finished Basement Unfin. Basement
DESCRIBE WORK
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
ILocation (Area)
Ownership
Public ❑ Private ❑
Req'd.
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
,45//ge
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NR ME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
;');'cia
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single
Building ..��
Plumbing ✓9` S e
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
03* *30,50
*3050 N
*30,506
A *0,00
1 3 0, 1
10 -02 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1';(1 02_8.0'
DATE ISSUED
1'3 0.2
PERMIT NO.
*30.50°
TOTAL