1980, 02-20 Permit: 80-1365 Gas PipingPLAN 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
1. 3GI5. N• CBMEiuT
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
3.
4.
OWNER
.Swvwcs SoFAS A
ADDRESS
3-7n E, 12."
CONTRACTOR -
ADDRESS
PHONE
534-gogc •
ZIP
9gzoz.
PHONE
ZIP
5.
DESIGNER
PHONE
ADDRESS
ZIP
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Valuation Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area Storage
•
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
NEW
0 BLD.
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. pS1 MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.
DESCRIBE WORK
Ws-rn .C_ 3' C4A5 PIPINg
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
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•e'ranting of a permit dyes not presume
to give authority to violate or cancel the provisions of any other state or ocal law regulating c. struction or the
performance of construction.
TE 71'9
DA
SIGNATURE
DEPT. .
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SP dIICONDITIONS: r/
DATE /Q OFFICIAL
APPROVED
FEES COLLECTED
Single $
Building
Plumbing
Mech. GOO
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 6.00
PERMIT NUMBER
?O- /3G5-
DATE
3GS
DATE azo/BO
•
04+ *600
*600 .te
13642
02-20'-8.0
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BE'2. '171`81
OMIT.
1365=60'OfOaJ
0
U
0-
N