1980, 11-25 Permit: 80B-4143 Plumbing Fixtures-O
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SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
/7 ad --
LOT
2.
LOCK
SUBDfVISIO
OWNS
ADDRESS
CONTR OR
4 A Dit ss
rt 131'C)
PHONE
ZIP
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ILP sw
❑ BLD.
PHONE
ZIP
cfy 2 /
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
PHONE
ZIP
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
Ei--15LMB. ❑ MECH. 0 M.H. ❑ POOL
0 OTHER
Type Const.
Occupancy
Valuation
East 'West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Main Floor
Upper Floors
Area of Decks
Storage
Finished Basement Unfin. Basement
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms
No. of Dwellings
Req'd. Rec'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE GAS ELECTRIC
OF
UTILITIES
WATE R
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS % 6,&‘
DATE OF APPLICATION_ /I/2/ SIGNATURE OF APPLICANT !�°V��
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
/ ex' At
/ C) c- f /Qt2iits
Gs
-73:0
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L„ -
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing Gy C0
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) 3•
TOTAL $
',3* *20.00
*2000
*20.006
A *0.00 8
4142-
11-24-80
z 6479.
03* *300
*3.00 N_
*3.006
A *0.00
42502
11-25-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*a0/214
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DATA' IISSU L ...18 b'
PERMIT2 1 d 10O1AL
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