1980, 11-05 Permit: 80B-3280 Plumbing FixturesPLAN 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
JOB ADDRESS
LOT
2.
BLOC
C 04"// (1I/q —
K SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER /� /'
3 of .a r/,6 ., i.lof t
ADDRESS
f £ 1 ,e,i.� y-
CCONTRAC Ori
4. ADDRESS
�rt/ # M„01, 07
PH NE
4 //7/
ZIP
1rof7•
Required Set Backs in Feet
North 'South East West
PHONE
1 $7
Size of Parcel I Zone Classification
DESIGNER
5. ADDRESS
ZIP
ey�."j
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZI P
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
kr NEW
❑ BLD.
❑ ALT.
PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK , ,+J
8. #1 t ' - Gra; y{/ 4,4+/%//
VALUATION Sourc GAS
of
9. Utilities
ELECT
RIC 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 /d//2019. SIGNATURE,
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
�a-�-E'6 I�
DATE OFFICIAL, /`440s�✓2 i t<"�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
03* *4300
*43.00 17)
*43.006
A *000
327.92
01=15-80
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM4SA PERMIT.
011 5 8;0 4'5.0.01 g