1980, 03-20 Permit: P80-2421 Plumbing FixturesPLANNNUMBER
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.
JOB ADDRESS
LOT
BLOCK
rS?IOISN N 3e35,r_
D Is oN
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
PHONE
PARCEL. NUMBER/S
ADDRESS
ZIP
CONTRACTOR
4 PS /Cb/tSfric.c'IiG�-
5.
6.
A DRESS
Vr /D6z95 /
4C€I6A. ✓
PHONE
/914g.,7 ge2A
ZIP
Required Set Backs in Feet
North 'South [East 'West
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area In Sq. Ft.
ADD SS
CHANGE OF USE FROM
ZIP
2.ar?
DWL Area I Basement Area
1 Garage Area
Storage
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
0.i -NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. Ij�PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/5" P;x4wr_`s
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 •ranting of a permit does not presume
to give authority to violate or cancel the provisions of any other state law r g cprtstruction or the
performancg / of cor�st�tion.
DATE 3_/ f/
DEPT.
Env. Health
d SPECIAL APPROVALS
REQ'D. REC'D.
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
%'SME OWNER'S WARRANTY ` '_ VES ❑
No ❑
DATE VXDr5703FFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building %Q��`
Plumbing / ✓'C1
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) 4/Z-(3
( %
TOTAL $ / Z� v
PERMIT NUMBER
DATE
03* *48.00
*48.00
*48006
2ft2O@ *000 8
03-20-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A.,ERMIT.
0'512 O. 2421
*48100. Dai: