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1980, 03-24 Permit: P80-2575 Plumbing Fixtures'PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT .-. . 1 PERMIT NUMBER NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675. DATE APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS - 1. LOT 2. BLOCK ISDBDIVI3(; / P�K C:14, LEGAL DESCRIPTION — SEE ATTACHED 3. OWNER PHONE PARCEL NUMBER/5 ADDRESS ' ZIP Required Set Backs in Feet North 'South East 'West 4. CONTRACTOPS Rs 647 nsei ADDRESS {(%O 5. DSl6tS lEFi' eV": ADDRE$G, ©s 'i 'e 110, l z,90? b� PHJNE sas sa Size of Parcel - - Zone Classification Type Const. Occupancy Sprinklered ❑Yes ONo 0 Req'd. Valuation Building Area in Sq. Ft. CHANGE OF USE FROM 6. TYPE- Xj NEW 7. OF WORK' 0 BLD. DESCRIBE WORK 8. VALUATION 9. TO ' ZIP 7%7/ DWL Area I Basement Area Garage Area Storage Split Entry Split Level Rancher 0 ALT. 0 AD N. �PLMB. ❑ MECH 0 RPL. 0 MVE. Source of Utilities GAS 0 OTHER ELECTRIC No. Baths No. Floors No. Rooms Rec. Room • CERTIFICATE of EXEMPTION Req'd. WATER I hereby certify that I have read and examined this application and have read the :'NOTICE" provisions included On reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The rra ing of a permit does not presume to give authority to violate or cancel the provisions of any other state o4c j aw regng cope truction or the performance of n. cor/�$tructi DATE 3/al /'O - SIGNATURE DEPT. SPECIAL APPROVALS RER'D. REC'D. Env. Health . Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist �110ME OWNER'S WARRANTY YES ❑ SP ECI DATE3—aN—DFFICIAL lX 'YVYt Il Recd. Not Req'd. FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) ' TOTAL 03* *4300 *43.00 *43006 E *000 8 257.48 -- 03=24=80 6479: • WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A BERMIT. 013:'-2'4''- 0 2517,55 *43,00:2 1.2 APPROVED FOR ISSUANCE _ 0 O CLCflw