1980, 11-07 Permit: 80B-3429 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
JOB ADDRESS
7°/6
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
CONT'IACTOR
4. ADDRESS
5.
PHONE
ZIP
PHONE
PARCEL NUMBER/S
2b -as =yam
Actual Set Backs in Feet
North !South [East (West
Size of Parcel
Zone Classification
DESI,ER /
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor I Upper Floors
Building Area in Sq. Ft.
AD DyltESS
3o33o3o M e55 /`01j
ZIP
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
El BLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL
8.DESCRIBE WORK ��/�• � 4V5 6/ X f.
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITI ES
GAS
ELECTRIC
WATER
SEWER
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 r- ulating construction or the
performance of construction. SEE REVERS SIDE FOR REQUIRED INSPECTIONo
DATE OF APPLICATION L' e�ii SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Tec ian
SPECIAL CONDITIONS:
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 2-/r)
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
P:=r2MIT NUMBER
5-04-3-3.
/21
03* *40,00
*40,00 N
*40006
A *000
34282
11-07-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l'li a'7—i:8
DATE ISSUED
342.91 *40.008!
PERMIT NO. TOTAL