1980, 06-02 Permit: 80-5189 Sprinkler SystemPLAN U BER
SV
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.
4.
JOB ADD`-R��EES,1Sy rW,,
LOT LOCK 1UBI ,,or)OLI f
LEGAL DESCRIPTION - SEE ATTACHED
5.
OWNER
ADDRES
mR S "v -E m"Ct+E .15
Pirn J%A BCK
CONTRACTORNcli _m fm k
A RESS771 '�X
dPt 52x1 '' "-(2tR
DE IGNER
Soirnc Po Cem-facloL
ADDRESS
ZI P
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
[East
(West
PHONE
Size of Parcel
Zone Classification
znictoice
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
NEW ❑ ALT.
❑ BLD. ❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH:❑ M.H. ❑ 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.
pe.11.)re12- 3yoit31\.
ELECTRIC
Source
of
Utilities
GAS
WATER
SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
R EC' D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATELQ. `f!0 OFFICIALQ.-.1C.C1...`VLJ'A.CcV
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
c.
Plumbing r )
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) 5,50
5P2ff .1 o1e1L...
TOTP(L`5� $ iJ1 50
PERMIT NUMBER
DATE
*5.50
*550
p *5506
U *000
51882
06-02-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`61-02'-80
518,95 *5.5021