1980, 06-23 Permit: 80-6173 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 3 COPIES
1.
2.
3.
JOB ADDRESS v
S 2-110 Cy
i,' UZ,,t)
LOT BLOCK SUBDIVISIO
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
re
ke(,))/u I�AU'' O 04)
ADDRESS
PHONE
928 -36A) 5
ZI P
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South lEast (West
CONTRACTL� ' Jg4 0/11i0V> / ff
4. ADDRES a /34 az/t_}
_}
5.
DESIGNER
PHONE
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. 4PLMB. ❑ MECH. ❑ M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
CERTIFICATE
of EXEMPTION
Req'd.
Enum. Dist. I Location (Area) r
ELECTRIC
WATER
SEWER
Ownership
Public El 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 reiulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT' fa J
DATE OF APPLICATION v 0 • SIGNATURE OF APPLICANT��
SPECIAL APPROVALS SPE IAL CONDITIONS: `�
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Build Te iciap-
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
13
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
(32
Other (Specify)OO
TOTAL
$3 O
RMIT NUMBER
-6/75
03* *35.50
* 35.50 V)
* 35,506
E *0.00 S
617.22
06-23-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
-8 '0
PERMIT NO. ', J z 5 7O'TAL