1980, 04-15 Permit: 80-3534 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
2.
3.
JOB ADDRESS
LtT,(2#
LO
OWNE
C inti
ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISI N
Fla/ /la7tov..
PARCEL NUMBER/S
70505 -Masa
zp
Required Set Backs in Feet
North 'South
East
West
CONTRACTOR
4
l./4 /97 S'
)17 Pr
Edo sft, etc/
DESIGNER 1
5. ADDRESS
PHONE
2' -7 3/S
PHONE
Size of Parcel ' 1 Zone Classification
ADDRESS
Type Const.
Valuation
Occupancy
_ Spnnklered
❑Yes 0No 0 Req'd.)
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
SPlit Entry
Split Level
Rancher
7.
TYPE
OF
WORK
❑ NEW 0 ALT.
0 BLD. ' 0 PLMB.
0 AD N. 0 RPL. 0 MVE.
0 OTHER
❑ MECH: 0 M.H. ❑POOL
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE -
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DE RIB =W`ORK n0
8. 3d/.dvd,atm
VALUATION Source
of
9. Utilities
GAS
LECTRIC
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 or local law regulating construction or the
performance of construction.
DATE 41-/5-.0
SIGN ATU R Ell(‘ .. -4
DEPT.
SPECIALAPPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
4—?e)�%�
DATEE OFFICIALA0.4 / Aida
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
/0,so
TOTAL $
PERMIT NUMBER
DATE =i'-15-1.49
03*- *1050
-*1050
*1Q506
E *000
'35-33g
04=15-80
2 64.79.
-t
WHEN MACHINE VALIDATED IN THIS SPACE,
THISaACOME3 AP€RMIT.
4 i1'i:YB'Oi 3'54= *10,50°L..
CC
1-
1-
az0-
V")