1980, 10-06 Permit: 80B-1442 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDINGCODES 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
S- /SoS f2Zc.Qan��
LOT BLOCK SUBDI ISION
LEGAL DESCRIPTION — SEE ATTACHED
OWN
AD/cm
PHONE
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South lEast 'West
4.
CONTRACTOR
(7020 SP64-t,
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Oyes 0No 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE 0 NEW
7. OF
WORK ❑ BLD.
tS'RLT. 0 AD N. 0 RPL. 0 MVE.
y_PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
1
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
8.
DE RIBS WO.ys7/R.fRK ,
9.
VALUATION
SOURCE
OF.
UTILITIES
3 jJYU?s
Enum. Dist.
Location (Area)
GAS
ELECTRIC
WATER
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC •NS
DATE OF APPLICATION/el -d _' SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bull Ing Tech
SPECIAL CONDITIONS:
..a t'44.21uca--1-429eta /"-7-0 0
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing /0.50
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /11:2S
PERMIT NUMBER
kn t3-/ le2
03* *1050
*1050 N
*105025
A *0.00 8
1,4412
10=06-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.4:0 h;o: 6;_;,g,Oi
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
•
t'
1.4.4 2'1
PERMIT NO.
*10,5:0ar2 -
TOTAL