1980, 12-30 Permit: 80B-5341 Plumbing FixturesPLAN NUMBER
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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 3 COPIES
JOB ADDRESS
LOT
2.
Dll � Mitt we-'/
BLOCK [SUBDIVIS ON
LEGAL DESCRIPTION — SEE ATTACHED
3
4.
5.
OWNER
ADDRESS
/A 72/ E"- 5(i)r.>-g w c�
GONTRPTORi7 z
NOI% (;04,4.
ADDnsA
f •V• I�ox 1 0?1/
DESIGNER
ZIP
2.?(OR/4
PARCEL NUMBER/S
Actual Set Backs In Feet
North 'South East 'West
PHONE
inc-577'
Size of Parcel
Zone Classification
ZIP
qua//
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ONo 0 Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
%NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. riSNPLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R eq'd.
Rec'd.
Not Rebid.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
Ifr-
S
P1 - I X
ELECTRIC
WATER
GAS
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 la eg,pting construction or the
performance of construction. SEE REVERSE�/SIDE FOR REQUIRED INSPECTION'
DATE OF APPLICATION ) p2 ! 7 /U V SIGNATURE OF APPLICANT r tJ
SPECIAL APPROVALS .-
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu Iding' echniaan
SPECIAL CONDITIONS:
/ —TCCQr
I Ske oCr'
fo; lc l5
g -
1- K; • 6;Aik •f
! - AI D tact -514e1' 1
K1 e Gc�a.4e,' 4e tell
1 - rioo r &,-a, ;
% — A reoL Dr—at/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
3c�, /q -
,Plumbing 1�
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�''22/���
PERMIT NUMBER
goer- 534-
03* *3000
*3000 63
*30.006
A *0.00 3
5340=
12-30-80
g 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12,=3 a'tit 6.i
DATE ISSUED
5134112. *3`:0pa -
PERMIT NO. TOTAL
0
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