1980, 02-07 Permit: 80-935 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
p
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. S .
LOT BLOCK SU DIVI ION
2.
OWN
3.
A
4.
LEGAL DESCRIPTION - SEE ATTACHED
ADDRESS
cl1, . .S vv_,'
DESIGNER
5. ADDRESS
PHONE
9 9eGo
zip
PHONE
ZIP
? 9 13 7
PHONE
PARCEL NUMBER/S
Required Set Backs In Feet
North 'South
Size of Parcel
Type Const,
Valuation
Occupancy
lEast 'West
Zone Classification
Sprinklered
❑Yes ENO ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area 'Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
CJ M1tEW
❑ BLD.
D ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
®'15.LMB. ❑ MECH: 0 M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WORK
VALUATION Source.' G S ELECTRIC
of
9. Utilities
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 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.
DATE vT��S/aCI)
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE ��,= FFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL S 0�
PERMIT NUMBER
so-- q3sI
03* *1aoo
*1aoo N
*1800'6
B *000 S
9342
02-07-80
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMEA ,F,RMIT.
0 .'— 0 —'�' 0' 9 3.5 5 * 18, 0 0 . ,
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
<' =41
451tsGC,
1 (i fl