1980, 04-04 Permit: 80-3097 Plumbing FixturesWY
PLAN 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. / //3-02/ /7 /nY/,)
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2,
BLOCK
SUBDIVISION
PARCEL NUMBER/S
3.
OWNE
ADDRESS
4.
a,2ee e,e
li
A
70M-0309
//�a/
CL1iJW
COI4TRA C -TOR
5.
• \g70 7
DES' JNER
ZI P
9020&
Required Set Backs In Feet
North 'South [East 'West
PH NE
5120 of Parcel 1 Zone Classification
/770
PHONE
Type Const.
Occupancy
Sprinkleretl
Dyes ONo D Req'd.
Valuation 1 Building Area In Sq. Ft.
ADDRESS
21P
DWL Area Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
D NEW
D BLD.
l`El ALT. 0 AD N.
Kr, PLMB. 0 MECH:
D RPL.
❑ M.H.
0 MVE.
0 OTHER
0 POOL •
No. Baths
No. Floors
No. Rooms
Rec. Room
- CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
D ESC RI RK
VALUATION
-ova;+C a,e. - acC-D
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that 1 have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Ut lilt les
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FOR GAS:
PIPE SIZES:
PIPE LENGTHS:
BTU'S:
DATE O1' FFICIAL4 F 1 CA.A • '
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
•
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
t?-` 0-30'V7
DATE
0 3`* *1050
* 1Q50 i
* 10506
*000
• 309.6
04=04. 80
2 6479.
i
WHEN,MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES.( PERMIT.
CC
1-
✓
Lu
rn
310'9.71 *10,5,021 ff
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