1980, 05-08 Permit: 80-4490 Plumbing FixturesJV6 HUUK tJJ
NJ APPLICATION/PERMIT I [PERMIT: NUMBERSPOKANE COUNTY — BUILDING CODES DEPARTMENT' x`40
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ArrLIUANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
PARCEL NUMRFR/c
OWNER
PHONE
3. O
53�F-�7S7
ADDRESS
E 30 STA ZIP
q Actual Set Backs in Feet
CONTRACTOR ` gZOZ North South East West
Size of Parcel
CSA,�E PHONE Zone Classification
4. ADDRESS
phZIP Type Const. Occupancy Sprinklered
DESIGNER ❑Yes ONO ❑ Req'd.
PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Ug
pper Floors Garage Area Storage
6. CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
TYPE NEW ❑ ALT ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Stories No. Rooms No. of Dwelling
7, OF �/ 11 OTHER
WORK 1:1B -Lb• LK PLMB• ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'(
DESCRIBE WORK of EXEMPTION
8' "1
{ ii 'F' Enum. Dist. Location (Area)
2E5 FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC I WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public ❑ Private ❑
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included Single $
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 Building
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 INSPECTION Plumbing IS•Sv
DATE OF APPLICATION SIGNATURE OF APPLICANT
� �j_..-- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health Fhcr,-t2E5
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
an PERMIT IS NONTRANSFERABLE
$ 8 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ I-
03* *15.50
* 1 5.50
* 1 5.50
B *0.00 U
44x92
05-08-80
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
05�-0�='80 44'9.0
DATE ISSUFfI oconnir 11^
*15.5.000
L