1980, 03-27 Permit: 80-2750 Plumbing Fixtures?LAN 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
LO BLOCK
SUB IVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
DRESS.
J.-&-c:3L?
CO,NTRAACTOR Pl
ADDRESS 11
DESIGNER
5.
ADDRESS
PHONE
.27J
ZIP
99.A56
PHONE
47Z /1-9'el 7
PARCEL NUMBER /S
Actual Set Backs in Feet
North 'South
Size of Parcel
'East West
Zone Classification
ZI P
got/ 4,
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
¢e PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
9.
�DESCRIBE WORK y//�
ALLU SOURCE 4L �LAS4 „TR1C WATER SEWER
OF
UTILITIES
Enum. Dist. I Location (Area)
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 3 -.2 7 9U
SIGNATURE OF APPLICAN�G,�y
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
Building T chnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
nO
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
4)
TOTAL $
PERMIT NUMBER
gyp— -757)
03* *2300
*23.00
*23006
E *0,00 8
274,98
03 -27 -80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
P3'-27-8.0 27'5.0 *23,0021 —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL