1980, 11-07 Permit: 80B-3423 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 3.COPIES
1.
2.
3
JOB ADDRESS
LOT
BLOCK
SUBDIVISION j/� 44 0.---)CLO
cJ
/
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
Actual Set Backs in Feet
North 'South East 'West
CONTRACTOft,&'D//
4.
ADDRESS
(E', 0.-7R/ 5/01-52-w;-,
b. Pn
ADDR(n/SI Vy^, /�� iC iq
CHANGE OF USE _'OiRO(�
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Area of Decks
Upper Floors Garage Area
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
�u r.FW 0 ALT. . 0 AD N. 0 RPL. 0 MVE.
0 BLD. IA4LMB. 0 MECH. O M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Roorns
No. of Dwellings
CERTIFICATE
of EXEMPTION
Rebid.
Recd.
Not Recite].
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
// --; X fit rrP rs
GAS ELECTRIC I WATER
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 lawre' / r cons ion Jir the
performance of construction. SEE EVERS SIDE FOR REQUIRED INSPECTIONS
.. 1.
DATE OF APPLICATION
SPECIAL APPROVALS
re NAME DATE
Env. Health—
Planning
ealth
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
/—BWldingT loan'
•
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
FEES COLLECTED
Single $
Building
Plumbing
Mech. ,
Plan Check
SEPA
Mobile Home
Other (Specify) ,,yy....
r. o e
TOTAL $ �x
71 PE.2!41T NUMBER
,5/00-36/-2-S
03* *3Q00
*3000 tz
*30.006
A *0.00 0
3422
1.1 -07-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
li�1r:�0,�a,8'O
3:.4223= • 1431.0,01 -
›-
0-
0 0-
0
LLIJ
LL