1980, 02-19 Permit: 80-1306 Plumbing FixturesPLA" NUMBER
FEES COLLECTED
APPLICATION/ PERMIT
VALUATION ource GAS ELECTRIC WATER SEWER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
9. utilities
Single $
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
Building
JOB ADD RE
to authority to violate or cancel the provisions of any other state or local law regulating construction or the
LEGAL DESCRIPTION - SEE ATTACHED
give
performance of construction.
Plumbing
d�
Mech.
LOT
EILO K
SUBDIVISION
Plan Check
PARCEL NUMBER/S
2.
Env. Health V
ei
SEPA
Planning
OWN E
/--
/ �—
PHONE
3.
Mobile Home
CZiL L(/l i'
3 0"
Co. Engineer /%_
Other (SpeFify) —'
� 1 �
ADDRESS
Utilitiesi1L.Er�(/
GCS 17
1n�
TOTA L $
ZIP
Required Set Backs in Feet
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES PERMIT.
=
North South East West
DATE_�/� 0FFIC
�
CON CTOR
PHONE
Size of Parcel
Zone Classification
L
e x "—/- 3 L.
4.A
RESS
ZIP
Type Const.
Occupancy
Sprinklered
0-311
Dyes ❑No 1:1Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors I No. Rooms Rec. Room
TYPE FYNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 11 BLD. L�'PLMB. ElMECH: EDM.H. El POOL
of EXEMPTION
PERMIT„NUMB R
P�
DATE
3* *28.00
*2:'i_i0
28.0011
E *0.^"
02-19-80
6.479.
DESCRIBE WORK a
FEES COLLECTED
8 `�
VALUATION ource GAS ELECTRIC WATER SEWER
of
9. utilities
Single $
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
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to authority to violate or cancel the provisions of any other state or local law regulating construction or the
give
performance of construction.
Plumbing
DATE 24� SIGNATURES
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health V
SEPA
Planning
/--
/ �—
(.
Fire Marshall
Mobile Home
3 0"
Co. Engineer /%_
Other (SpeFify) —'
� 1 �
Utilitiesi1L.Er�(/
GCS 17
1n�
TOTA L $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES PERMIT.
=
L 1 S i U ,' 'I,
DATE_�/� 0FFIC
�