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1980, 02-27 Permit: 80-1570 Plumbing FixturesPLAN N -UMBER r 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 1. 2. 3. 4. JOB ADDRESS L T BLOCK IUBDIVIS LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S 5. OyfNE� ADDRESS 1, /. // J3za'ac�424-1244e_t- CONTRACTOR wwAA'',, PHONE zlo-9oz ZIP 94.2-d� PHONE Required Set Backs in Feet North 'South [East 'West Size of Parcel 1 Zone Classification ADV ESS DESIGNER ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No El Req'd. PHONE Valuation (Building Area in Sq. Ft. ADDRESS ZIP DWL Area l Basement Area r Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Split Entry Split Level Rancher ❑ NEW ❑ BLD. ❑ ALT. A PLMB. D AD'N. O MECH. O RPL. O M.H. ❑ MVE. O POOL 0 OTHER No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. DE/�S.CRIBE 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. The .sting of a permit does not presume to give authority to violate or cancel the provisions of any other state • loc.I law regulating constructi•. or he performance�jof construction. DATE 2. -.Z7 -8a SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist IC:ME OWNER'S WA RANTY __ YES L No FEES COLLECTED Single S Building "///plumbing ch Plan Check SEPA Mobile Home Other (Specify) SPECIAL CONDITIONS: a2-27—?D DATE OFFICIAIOCt;(.44W1-/ APPROVED FOR ISSUANCE TOTAL $ PERMIT NUMBER ?4'""' 7D DATE -2- — 03* *15.50 * 1550 * 15506 B *000 8 1569B 02-27-80 B 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 02L'2'T='8 '0' 157.02 *1550a