1980, 07-17 Permit: P80-7236 Plumbing FixturesFLAN N UMBER
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
it/i 13/6
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
3
4.
OWNER
ADDRESS
CONTRACT)
ADDRESS
/e
5.
ADDR
PHONE
ZIP
Required Set Backs in Feet
North 'South
East
(West
ill
6.
.G.
5 ,1 tz..fd �',
��
1�•�/, / '
CHANGE OF USE FROM
TO
PHONE
ZIP i�I�'"
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZIA
Valuation
Building Area in Sq. Ft.
DWL Area I Basement Area r Garage Area I Storage
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
Ild'MEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ BLD. LMB. ❑ MECH. ❑ M.H.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
❑ MVE.
❑ POOL
❑ OTHER
1aCTLL rr�
ELECTRIC
GAS
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
/e
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 .f a permit does no presume
to give authority to violate or cancel the provisions of any other state or to I: ;�eguIat nstruc n or the
performance off onstryction.
t
DATE
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Mar shall
Co. Engi neer
Utilities
Zone Clearance
SEPA Checklist
hOME OWNER'S WARRANT'
YES 0
NO C_'1
SPECIAL crO • ITIONS:
DATE? '7_a OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
- 7 36
DATE 7- / % 8U
*30.50
*3050
*3Q50U
E *000
723.52
07 -17 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
721,6 z *30.502
RECORD OF INSPECTIONS
DATE REMARKS
*
Final Inspection
INSPECTED BY
E
*2024
*2C'20
*2O''20