1980, 05-23 Permit: 80-4955 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
1.
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIV 1510
PARCEL NUMBER/5
3.
OWNER
A DRESS
I
CONTRACT/0R
t"rl'r_ie. 5a t1i
y4'd
PHONE
ZIP
9/Ane
PHONE
Required Set Backs in Feet
North 'South [East [West
Size of Parcel
Zone Classification
' ADDRESS _
ZIP
Type Const.
Occupancy
Sprinklered
Oyes DNp 0 Req'd.
5.
6.
ClEeeMeifeR
P a1
PHONE_
334—i'e7
Valuation
Building Area in Sq. Ft.
ADDREP1O1 ga 1407//� /
CHANGEl[iOF USE FROM
ZII99,,,
DWL Area
Basement Area
Garage Area
Storage
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
QkNEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. *LMB. 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
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utihtle.
GAS
ELECTRIC
WATER
SEWER
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 9tlo% 1 law regulating,Fonstruction or the
performanceuction.
�1f cons
' 5 L5 /t2 SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
6,
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
LHOME OWNER'S WARRANTY ''`` YES ❑
NO ❑
SPECIAIIOONDITIONS:
DATESrn/rz (OFFICIAL •4 1' CRAA -vv
APPROVED FOR ISSUANCE
FEES COLLECTED -
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $ 7 3,e
PERMITJcUMBER
-P-WD Th
DATE
03* *2300
*2300 5
*23.006
E *Q00 S
49542'
05-23,-80
2 6479.
IS
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COM IA ERMIT. .
i��i;—;�'0 495,'SZ *23,00°�
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U
0-
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