1980, 07-01 Permit: 80-6585 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
ADDRESS
.
v %7/
CON CTOR 7/�iJA
'7 7 ti,/L/.v
4'
ADCS8SS
DESIGNER
5' ADDRESS
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
Actual Set Backs in Feet
North 'South East 'West
PHONE
92r -J'2 3
ZIP
f2 -/l
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Ves ❑No 0 Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
53. --NEW
0 BLD.
❑ ALT.
.M B.
❑ AD N.
O MECH.
❑ RPL.
❑ M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths ,
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
/3 ��oacer/
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
5 I ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 ordiriances 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 regulating construction or the
performance of -Construction. SEE REVERSESIDEFOR REQUIRED INSPECTIONS
//toDATE OF APPLICATION 7 SIGNATURE OF APPLICANT"
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME. DATE -
Env. Health
Planning
Fire Marshall
Co. Engineer
• Utili
Plans Examine
SEPA Check!
Fp
.v 16
2- -S AteGui24,
122- u, /kV
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other lSpecify)
TOTAL $ OsS
SD
P
PERMIT Naze -
go a &85.
03* *3550
*35.50 ti
*3.5.506
8 *000
658.4.2
07-0,1'-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. .
tIN:Iliolit7 810
•
6 •'5' 8,5 2 •* 3 55 ---
PERMIT NO. TOTAL