1980, 12-30 Permit: 80B-5343 Plumbing FixturesPLAN NUMBER
0
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
JOB ADDRESS
1.
LOT
2.
BLOCK
SUBDIV / t /ON �/OtXW' L//
t
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
5.
OWNER
AID/7 co6Ls-E
PHONE
�a�-yos7
PARCEL NUMBER/S
ADDRESS
/� zR r Sp racy
CONTvgAb OR
Nr
ZIP
9901/6
Actual Set Backs in Feet
North 'South
East 'West
PHONE
,S"35 X8'76
Size of Parcel 1 Zone Classification
A RESS�7
�D. IOnx
DESIGNER
11/09,
PHONE
Type Const.
Occupancy
Sprinklered
Dyes ❑No 0 Req'd.
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
K.NEW
0 BLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE.
KPLMB. . 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
DESCRIBE WORK
8.
/0
1.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
I u
ELECTRIC WATER
Enum. Dist. I Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 la r ulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI
DATE OF APPLICATION / (Rip., /O SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
eal
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPE51/ L NDITIONS:
DIA, er-
- O.i
l K; 4.6 ,0k
/— AJt', £6o sler 1
/J - t ///e , ZO a'. -1d /4tel e r'
/ / loo •• V r-aC-; N
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
•I PERMIT NUMBER
/ IAB -5'343
03* *2a00
*2800
*2a006
A *0.00 0
534.2,2 •
,12-30=80
6a79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1'2+3;• o- '8 b'
DATE ISSUED
51,3.0'Zi * 2 & O O a �.
PERMIT NO. TOTAL
0-
1
O
UJ
LL