1980, 05-16 Permit: 80-4861 Plumbing FixturesPLAN NUU MBER
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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
LOT
2.
BLOCK
6DD71 m° 4,3a
LEGAL DESCRIPTION — SEE ATTACHED
3
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
Required Set Backs in Feet
North 'South [East `West
4.
CONTRA• CTO{2/� // j� 146/
-13811
Size of Parcel
Zone Classification -
2P9.„?06
- Type Const.
Occupancy
Sprinklered
❑yes ONo 0 Req'd.
5. 13Gciei Pt P•
//.
ADDrt .Sok /OW
CHANGE OF US FROM
6.
TV PE .NEW
7, OF
WORK ❑ BLD.
DESCRIBE WORK
8.
PHONE
635-55'A
Valuation I Building Area In Sq. Ft.
TO
Z/74;//
OWL Area
Basement Area 1 Garage Area
Storage
Split Entry
Split Level
Rancher
0 ALT. 0 AD N.
APLMe. 0 MECH
0 RPL.
0 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.
9' /� i x
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
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. T a f g of a permit does not presume
to give authority to violate or cancel the provisions of any other state .r I.4.: aw regulating co ruction' or the
performance o cons7 uc I
DATE
3
SIGNATURE
DEPT. '
SPECIAL APPROVALS
REG'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
• HOMEOWNER'S WARRANTY
SPECIAS.NDITIONS:
YES CD AT Eep(nf1. I OFFICIAL 1'r k_+ ' \n M11PSINA.
NO APPROVED FOR ISSUANCE
FEES COLLECTED ' -'
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
41
PERMIT NUMBER
P%fl-4%71
DATE
03* *2550
*2550 V)
*25506
E *0.00
48608
05=16-80
42479.
•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
a i; '111.07; 8'0 48'6:1 5 *25.542�