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1980, 11-24 Permit: P80B-4141 Plumbing Fixtures!PLAN 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 3 4. JOB ADDRESS LOT BLO K OWNER ADDRESS CONTRA SUBDIVISION` - - t/ PHONE ZIP PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER /S Actual Set Backs in Feet North South Size of Parcel D ft ESS /32 6 _3 �G►�fiC E� DESIGNER J. ADDRESS CHANGE OF USE FROM 6. TYPE 7. OF WORK ZIP PHONE ZIP TO ta-N-EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ BLD. -gYPLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER DESCRIBE WORK 0 VALUATION 9. SOURCE OF UTILITIES G ''ELECTRIC Type Const. Occupancy Valuation Main Floor Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. Upper Floors Garage Area Storage Area of Decks No. Baths Finished Basement Unfin. Basement No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Enum. Dist. Req'd. Rec'd. Not Req'd. Location (Area) WATER SEWER Ownership Public ❑ Private ❑ 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 INSPECTIONS DATE OF APPLICATION SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: c �? Vic/ U, PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) Cis TOTAL $ O..'q 1 PERMIT NUMBER 03* *53.00 *53.00 *53.006 A *000 g 414,02 11 -24 -80 R. 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUED 43412 *53.00 0 � PERMIT NO. TOTAL