1980, 01-21 Permit: 80-400 Plumbing FixturesPLAN NUMBER
i
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (5091 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1.77175.--- sit
LOT
2.
3�
Cr ACTOR
4./&
DESIGNER
5' ADDRESS
BLOCK
SUBDIVISI
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LEGAL DESCRIPTION - SEE ATTACHED
.-601,
ZIP
ez a6
PARCEL NUMBER/S
Required Set Backs TiIFeet
North !South ►East (West
flan: z
Size of Parcel 1 Zone Classification
r9477/6 -
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation ►Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
L7NEw ❑� ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
CsrZ g o. LT PLMB. ❑ MECH: ❑ M.H. ❑ POOL
8. DE RIB ORr�L
V L ATION
9.
Source
of
Utilities
❑ OTHER
.ze.5
No. Baths
7
No. Floors No. Rooms
TEil
CERTIFICA
of EXEMPTION
Req'd.
Rec, Room
Rec'd.
Not Req'd.
GAS
ECTRIC
TER
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 granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or loca w re' . atin8 construction or the
performance of construction.
DATE ts2A SIGNATURE 41.-1,111;( '�
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL
APPROVED FOR ISSUANCE
,Ca-izrat
FEES COLLECTED
Single $
Building
S.°
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 0/6
p
PERMIT NUMBER
V— 'WD
DATE /—,2/—gd
03* *2550
*2550
*25506
E *000
39.98
01-21-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISd.ECLO F A AORMIT.
'4a *25.501i
eY
U
W
0—
Ci)
C/7
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
01 --SJ
4