1980, 10-02 Permit: 80B-1285 Plumbing FixturesPLAN NUMBER
JOB ADDRESS
1. X11
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
I LEGAL DESCRIPTION — SEE ATTACHED
OWNER (PHONE
3. /-r-- iivsKI
ccs-�oc.T
DRESS
AD�
ZIP
Actual Set Backs in Feet
, D
T• 0- O % y f16
(J
" /i qzi
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
co Gum /ti
Z38 -6Z8
4.
ADDRESS
ZIP
Type Const.
Type
Occupancy
Sprinklered
111 doceA./T2 /I,-0,WE,S bco
'l`7 Z10$!�
1
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area I
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
Baths
No. Stories
No. Rooms
No. of Dwelling
TYPENo.
KNEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El OTHER
❑ BLD. I1 PLMB. ❑ MECH. ❑ M.H. El
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8 Fl u,�ES
VALUATION
SOURCEGAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
I UTILOITIES
Public 1:1 Private ❑
Single $
1 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
Building
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 regulating construction or the
'�8
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
V (
Mech.
DATE OF APPLICATION O " SIGNATURE OF APPLICANT
SPECIAL APPROVALS ECTAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
es
Plans Examiner
SEPA Checklist
Building Technician
PERMIT IS NONTRANSFERABLE
TOTAL $ 49. Gid
PERMIT NUMBER
g0 a — 1 Z85—
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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r-(}?=gU X28.5
*18,00.0,- -