1980, 06-19 Permit: 80-6011 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 4 COPIES
JOB ADDRESS
1 aza�c �Yc LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S
OWNER
3.
ADDRESS
CONT".OR
4' ADDRESS
5. D"44� P a;
CHANGE OF USE FROM ITO
6.
PHONE
ZIP
PHONE
I�
PHONE
I vrt .NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
OF
% WORK 1-1 BLD. XZL.MB. ❑ MECH: 1-1 M.H. ❑ POOL 11 OTHER
n
ize of Parcel
Type Consi7 Occupancy
aluation
OWL Area Basement Area
Split Entry Split
No. Baths No. Floors
CERTIFICATE
of EXEMPTION
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
.evel Rancher
No. Rooms Rec. Room
Req'd. I Recd. INot Rei
DESCRIBE WORK
8. F
j , `" ! FEES COLLECTED
VALUATION Source GAS ELECTRIC 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 lawvjnd ordinances governing this Building
type of work will be complied with whether specified herein or not. The g i f a permit does not presume
to give authority to violate or cancel the provisions of any other state or I call w regulating constr ion or the
performance o constru do Plumbing
DATE NO SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIAL ?7 ITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
PERMIT NUMBER
v
DATE
Co. Engineer Other (Specify)
Utilities
TOTAL $ ��//
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Chekbist :... THIS BECOM45SIPy PERMIT.
p ne�►...� r = �.
DATE (LJi__ FFICIALA
--- �----- MAT � 9'.: Jilt
9 11 i
': U. , i r4
r
-�
Z!
?.
Co. Engineer Other (Specify)
Utilities
TOTAL $ ��//
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Chekbist :... THIS BECOM45SIPy PERMIT.
p ne�►...� r = �.
DATE (LJi__ FFICIALA
--- �----- MAT � 9'.: Jilt
9 11 i
': U. , i r4