1980, 10-28 Permit: 80B-2999 Plumbing FixturesAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.4B JADDRESS
.^Z
LOT
2.
3.
BLOC
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
!Z Abf -Qi
PHONE
92y—ggo.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
CONTRACTOR
ZIP
4.
DRE
DESIGNER
5' ADDRESS
6.
PHONE
Actual Set Backs in Feet
North South
East 'West
Size of Parcel 1 Zone Classification
// l7 A-dau'tc . -),(f, &.
ZIP
9q.:7-//
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation 1 Building Area in Sq. Ft.
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors
Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
8.
❑ NEW
❑ BLD.
❑ ALT. 0 AD'N.
PLMB. 0 MECH.
DESCRIBE WORK Pi
ALUATION
9.
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 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /e/
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
SOURCE
OF
UTILITIES
GAS
ELECTRIC1
ATER
t .
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bring ech ician'1
SPECIAL CONDITIONS:
-30- el
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
?.779
03* *8,00
*8,00 67)
*8,008
A *0,00
279.82
10-28-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,0-0%80'
DATE ISSUFD
279,92
PFRsAIT nit-)
*8.0.0 a
TI1TA I