1980, 10-07 Permit: 80B-1570 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
/i /e7 d
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BL
S BDIVISION
3.
OWNER
ADDRESS
PHONE
9z.cf 93 2/
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North !South East 'West
4.
CONT TOR
PHON
91.E `re3
Size Of Parcel 1 Zone Classification
ADDRESS
x3/32
ZIP
992-,
Type Const.
Occupancy
Sprinklered
['Yes ❑No 0 Req'd.
5.
6.
DESIGNER
PHONE
Valuation 1 Building Area In Sq. Ft.
ADDRESS
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE t NEW 0 ALT. ❑ AD N. 0 RPL. ❑ MVE.
7. OF 0 WORK 0 BLD. QNLMB. 0 MECH. 0 M.H. 0 POOL OTHER
No. Baths
No. Stories
No. ROoms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE C
OF
UTILITIES
etZfejLW
ELECTRIC
Enum. Dist.
Location (Area)
WATER
SEWER
Ow n e rsh 1p
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 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 (0/2/ed SIGNATURE OF APPLICANTy�A���ri�G��
SPECIAL APPROVALS
. NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
B, dIn• Tec )nlcia
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building �y C�
Plumbing , d O °,$ i
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1O4
f0
PERMIT NUMBER
g J 5 -?J Z4
03* *3800
*3800 b5
*3800
A *000
15692
10-07-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. -
PERMIT IS NONTRANSFERABLE 0.,0 Irk°. Y8 0i 1 r5 % 0 ? * 3, 8.0:0 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL