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1980, 07-15 Permit: 80-7132 Plumbing FixturesPLAN NUrit1ER. ". 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. 3 4. JOB ADDRESS `'` C LO! I LOCK r ISUBDIVISSIIONe—A LEGAL DESCRIPTION - SEE ATTACHED OWNER 4 el fIctentol ADDRESS SP ILI1b N (a:Lt a CONTRACTOR ADDRESS 5. 6. DESIGNER PHONE 6- SAM ZIP , v9za6 PARCEL NUMBER/S Actual Set Backs in Feet North (South East 'West Azzsionso (20•4414._ PI o1rA.u6 s33A' rl y CN Sr PHONE 7t t` 33'2 Size of Parcel 1 Zone Classification til%P ZIP B a5/ ./ Type Const. Occupancy Sprinklered ❑Yes UNo 0 Redid. PHONE Valuation Building Area i Sq. Ft. ADDRESS ii-' CHANGE OF USE FROM ZIP Main Floor Upper Floors 1 Garage Area Storage TO Area of Decks Finished Basement Unfin. Basement TYPE ,rg NEW 7. OF , WORK 0 BLD. 0 ALT. 0 AD N. 0 RPL. iq PLMB. 0 MECH. 0 M.H. O MVE. o POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Re 'd. Not Req'd. D SCR4B WOR , / /7��/d7— 8. 1AAiJo iiL f1' w4dKZ� ji 6o \i V LUATION SOURCE GAS ELE TRIC W• ER OF 9. UTILITIES Enum. Dist. Location (Area) SEWER Ownership Public D Private D 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 fl I 1 rr 4-0 SIGNATURE OF APPLICANTdQ 731 stn SPECIAL APPROVALS NAME DATE Env. Healt Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist B UJ(ding Tee niciary, 4Q L/ O4 SPECIAL CONDITIONS: I- C L.o I— LAJ 1— t^ur1 I — W W s 04.70— l— IGit- Siu.c .41-Q6u (conAr1rW6 'eiefrrycc.d.(.L'c^ % /' - PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building • Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ gD0 PERMYT NU—MINER W = 7/3Q 03* *1800 *1800 .65 *,19006 E ' *0.00 8 71312 07=15-80 ,2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUED 71'3.2 2 *1 & 0.0,2 PERMIT NO. TOTAL