1980, 07-17 Permit: 80-7284 Sprinkler SystemPLAN NUMt.
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
JB ADDRESS
l f:Jy r
LOT
BLOCK
SUBDIVI:
ION
OW(VER
3. 't L.tliu�/t��t Ci�%U
A DRESS V
1 >7
CONTRACTOR
PHONE
A/ 2 f11f®fti4
ZIP
L7t"3
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
,E.,- . art , /,
. G ,,:dx,t~,a - 4.4.i-ccil
4'
RESS
1 , f i 2,�! e7 ,j-‘M-tra..4-414Le
DEB.IGNER
5. ADDRESS
PHONE
Actual Set Backs in Feet
North !SouthEast (West
Size of Parcel Zone Classification
ZIP
Type Const. I Occupancy
CHANGE OF USE FROM
6.
TYPE
7. OF
WO RK
❑ NEW
❑ BLD.
❑ ALT.
PLMB.
PHONE
ZIP
TO
❑ AD'N.
O MECH.
❑ RPL.
O M.H.
O MV E.
O POOL
0 OTHER
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area
Storage
Area of Decks Finished Basement Unfin. Basement
DESCRIBE WORK
8. . 1.it ft ti o
VALU TION SOU CE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
No. Rooms
Location (Area)
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 loc 1 law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT!
_ATE OF APPLICATION 7 / 7- d SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
"fans Examiner
CEPA Checklist
B (//dy�ing Technic'
a�11 ;41)
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
J
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
f 1rIVIi1ivVIvIDGht
tT
3*
*550
*5.50
72832
07-17-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-:17 810 7 2 8.4 z
DATE ISSUED PERMIT NO.
*5.50 W. pi
TOTAL