1980, 03-28 Permit: 80-2828 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT IPERMIT NNUUMBER�
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
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*5.5006
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2 �R }.7 F
03 -2Q -8C
6.479•
VALUATION Source GAS ELE TRIC WATER SEWER
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
C'l
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
LEGAL DESCRIPTION — SEE ATTACHED
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
LOT
BLOCK
SUBDIVISION
performance of construction. Plumbing
PARCEL NUMBER/S
2.
SPECIAL APPROVALS SPECIAL CONDITIONS:
I
DEPT. REQ'D. RECD. Plan Check
Env. Health FOR GAS:
SEPA
OWNEW
Planning
PHONE
PIPE SIZES:
Mobile Home
Fire Marshall
PIPE LENGTHS:
3.
Co. Engineer Other (Specify)
Utilities BTU'S:
'
TOTAL $
ADD S
IN THIS SPACE,
ZI
Required Set Backs in Feet
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DATE /3I OFFICIAL
North South East West
CONTRA OR
PHO ESize
of Parcel
Zone Classification
�—
/ I
Ci
.
4.
AD
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mo
76)
ZI
�C�`—i L�
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE El NEW 1-1 ALT.
1:1AD'N.
1:1RPL. ElMVE.
7,
OF
❑ BLD. -.krPLMB.
❑ MECH:
❑ OTHER
❑ M.H. ❑ POOL
CERTIFICATE
Req'd. I
Recd.
Not Req'd.
WORK
of EXEMPTION
8.
DESCRIBE WORK
f
FEES COLLECTED
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*5.5006
F c. o
2 �R }.7 F
03 -2Q -8C
6.479•
VALUATION Source GAS ELE TRIC WATER SEWER
of
9. Utilities
Single $
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 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
performance of construction. Plumbing
DATE SIGNATURE— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health FOR GAS:
SEPA
Planning
_
PIPE SIZES:
Mobile Home
Fire Marshall
PIPE LENGTHS:
Co. Engineer Other (Specify)
Utilities BTU'S:
'
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
THIS B COMERS A,•ERMIT.
SEPA Checklist _ �
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DATE /3I OFFICIAL