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