1980, 01-08 Permit: 80A-9909 DishwasherPLAN NUMBER
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.
3.
JOB ADDRESS �! '
LOT
BLOCK
OWNER
ADORES
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
CONTRACTOR 9/27
4. —� ter_
ADDRESS
DESIGNE
5' ADDRESS
3 717
ZIP��J�
P�/.7v
J/d" //7o
/C/
ZIA5
,2-2G
PARCEL NUMBER/S
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.
ZIP
DWL Area I Basement Area ( Garage Area ` Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Levet
Rancher
7.
8.
9.
TYPE
OF
WORK
❑ NEW 0 ALT-
❑ BLD. PLMB.
DESCRIBE WORK
VALUATION
❑ AD'N.
O MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors No. Rooms
Rec. Room
Source
of
Utilities
GAS
ELECTRIC
Y
WATER
CERTIFICATE Req'd.
of EXEMPTION
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.
r
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
' Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $•>� /
DATE
PERMIT NUMBER
50-p%- gqo'
-,f/- 7,
03* *550
*550
*5506
E *000 8
99Q8
01-08-80
6479.
DATE 1— D 60OFFICIAL >Ll fY�IYI J
APPROVED FOR ISSUANCE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS 'COI ESA E,rMIT.
99Q9z *5.5.022