1980, 12-31 Permit: 80B-5404 Plumbing FixturesPLAN NUMBER
1
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
1.
2.
JOB ADDRE S
(�/ /J/ �r ,/ 'c&
LOT
B CK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 /
aj:72/27/, Cc
/7
ADDRE
1375/21C/
4.
CONTRACTOR -2,),),
,5 /46/77/6/!:/7
ADDRESS
Z117'7e
P ONE
Actual Set Backs in Feet
North 'South
East 'West
Size of Parcel I Zone Classification
ZI P,:7Z1/
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation (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
O NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ 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.
CRB/iK 1, &&e.,
l 7
SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
�``7R
Enum. Dist.
Location (Area)
Ownership
Public 0 Private ❑
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 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 /2 —._//zVRO SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS: j7
, /r /
1;;I'/e5- /Z?'
° l' C_. cal//7 Q7/
x177- T') '_i x /X5Vi-//07
/Y41/)/ 0j29 // r5. � 2244
PERMIT IS NONTRANSFERABLE
PFRMIT FXPIRFS ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
P
PERMIT NUMBER
SOB- 51`01-
0 3 *
01-
03* *15.00
* 1 0
* 1 800
* J. C ii
540,3f5
12-31-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
3,} 7i6t`
DATF ISSIJFr) PFRMIT NO TOTAI
54,441 *15'0020-