1980, 02-07 Permit: 80-947 Plumbing Fixtures1
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
2.
3.
JOB ADDRESS
/2)
LOT
LEGAL DESCRIPTION — SEE ATTACHED
OCK
SUBDIVISION
OW R
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PHONE
gad'- 9e60
PARCEL NUMBER/S
AD, ESS
/4I'//d
C N RACTOR
4. A DRESS
5.
c 069.4—
DESIGNER
ZI P
c%,1./7
PHONE PHONE
ZIP
' 742
PHONE
Required Set Backs in Feet
North 'South
East
lWest
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
Oyes ❑No 0 Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
P'14 --EW
0 BLD.
0 ALT. ❑ AD'N.
-MB. ❑ MECH:
0 RPL. 0 MVE.
❑ M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/c) ourct
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this application and have read the '
on reverse side, and know the same to be true and correct. All provisions of laws
type of work will be complied with whether specified herein or not. The granting
to give authority to violate or cancel the provisions of any other state or local law
performance 0/construction.
DATE 4::;2/67/ef"::) SIGNATURE
'NOTICE" provisions included
and ordinances governing this
of a permit does not presume
regulating construction or the
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE .2 1 1t tFFIC1AL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL S atcF
DATE
PERMIT NUMBER
03* *2800
*2800
*28.008
B *000 0
9&6A
02-07-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISOBECOME$ An MIT.
9478
*28.000..1-
RECORD
OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
p