1980, 07-28 Permit: 80-7733 Plumbing FixturesPLAN NUMBER 6
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.
JOB ADDRESS
792/ I�&-.wrsel/
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
5U Bb IVIS ON
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
CONTRACT( // /l�I 003/ 4' ADDRESS //
I/X72./El , �i)rctiv-G
,D
5.
6.
ADD
CHANGE OF USE FROM
ZIP
Actual Set Backs In Feet
North 'South
East
'West
3%--(3)70
Size of Parcel
Zone Classification
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unf in. Basement
TYPE
7. OF
WORK `•❑ BLD.
❑ ALT. 0 AO N. 0 RPL.
ZPLMB. 0 MECH. 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
// / `,
711-trei
eJ
ATER
ELECTRIC
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
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 r•. I . ng construction or the
performance of construction. SEE REVERS SIDE FOR REQUIRED INSPECTION:
�t
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health -
Planning
Fire Marshall
•
Co. Engineer
Utilities
Plans Examiner.
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
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
ERMIT NUMBER
�D-7733
03* *3Q50
*3050
*30506 -
E *000
77322
07-28-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0''7,=2`81- 8101
DATE ISSUED
77'3.3 *30.5:D
PERMIT NO. TOTAL