1980, 02-07 Permit: 80-939 Plumbing FixturesPLAN P'. )MBER
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
JOB ADDRESS
1. // ZV
LOT 1 BLOCK
2.
SUBDI VISION
3.
OW
ADDRESS
TRACTOR
4.
PHONE
ZIP
9 1a1 eo
PHONE
ZIP
9.9a.3 j
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South IEast (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation 1Buiiding Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
0 BLD.
&ALT. ❑ AD'N. 0 RPL. 0 MVE.
27 F'LMB. ❑ MECH: 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors No. Rooms
Rec. Room
Fl
CERTIFICATE Req'd.
of EXEMPTION
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/L:/�
(/' S rce GAS
of
Utilities
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 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. / L
DATE, . ��4 Cf SIGNATURE
z
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Flealth—
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single S
Building
Plumbing U�
I Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
DATE d. `_L_i.DOFFICIAL
Cly
APPROVED FOR ISSUANCE
TOTAL $ °�
PERMIT NUMBER
DATE --2�-�:/v
U3*
*800
*800 tn
*8006
B *000
93.88
02-07-80
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A P, RMIT.
02'-0�7-8'0' 9395
*O. 11 U0°a:1—
$�
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
OS -r.1-80
B x i7 C .. 8
rte. ow..