1980, 05-23 Permit: 80-4959 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 4 COPIES
JOB ADDRESS
LOT
2.
BLOCK
SuaDlvis o i
LEGAL DESCRIPTION — SEE ATTACHED
3
OWNER
PHONE
PARCEL NUMBER/5
ADDRESS
ZIP
Required Set Backs in Feet
North' 'South
East
'West
4.
5.
CONTRA OR.
t-r!D f. -a$')'1',
PHONE
Size of Parcel
Zone Classification
ADDRESS
N' 33'70 A 1`d[Lw 0 gr DrOGdr.t
TIPS LGpjF .
ZIP
a110p-�J
Type Const.
Occupancy
Sprinkiered
Yes ❑No 0 Req'd.
PHONE
535- "97,4
Valuation
Building Area in Sq. Ft.
ADDRESS
6.
Pr D' Wm( 2o 5/
CHANGE OF USE FROM
TO
ZIP
Ssai4/
DWL Area I Basement Area Garage Area
Storage
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
I NEW 0ALT.
M
0 BLD. PLMB.
❑ AD N. 0 RPL. 0 MVE.
0 MECH: 0 M.H. ' 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
DESCRIBE WORK
VALUATION
/17 /17 X 'Itt. re --
GAS
Source
of
Utilities
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The grant'nr of a permit does not presume
to give authority to violate or cancel the provisions of any other state or I.4 Ij regu ng c istruction or the
performance of con(struction.
DATE . /p!/O co SIGNATURE
DEPT.
SPECIAL APPROVALS -
REO'D. REC'D.
Env. Health
Plant, Ing,p•'.' •.
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA C ecklist
I HOME
OWNER'S WARRANTY
vEs Q
NO ❑
SPECIAL Ce Ir ITIONS:
DATE 'I(' l/��UFFICIAL 1 0" "^\
44 L APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL
PERMIT NUMBER
P -`b0 -1-H5A
DATE
$ J !l 'oz)
03'* *3800
*3800 y
*38006
E *000
49588
05.4-23:-80
2 6479.
CIM✓
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
5;r2151'e1810 49'5.9 zl *,3 8.0 0 g
CC
0
0
uJ
0
o_