1980, 12-12 Permit: 80B-4814 Plumbing FixturesNUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
JNORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE NEW ❑ALT. 13 AD'N. E] RPL. El MVE.
7. OF El OTHER
WORK -1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK / Enum. Dist. Location (Area)
- FEES COLLECTED
8. t t / I <`—
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
SOURCE
JOB DDSs
ELECTRIC
WATER
SEWER
LEGAL DESCRIPTION —SEE ATTACHED
USE CODE
LOT
BLOCK
JGAS
UTILLITIES
(?�
PARCEL NUMBER/S
2.
Public ❑Private C3
t
ISUBDIVISION
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
OW
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
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HO E ff�l'�
Plumbing
3.
1J.
DATE OF APPLICATION 12 J SIGNATURE OF APPLICANT
Mach.
SPECIAL APPROVALS
)
NAME DATE
ADDRESS
Plan Check
Env. Health
ZIP
Actual Set Backs in Feet
Planning
North South
East West
CONTRAOR11'x-
+ r
PHONE
Size of Parcel
Zone Classification
4.
ADDSS
ZIP
Type Const.
Occupancy
Sprinklered
r,x[j
I�;
❑Yes [-]No 1-1 Req'd.
DESIU!NlEK
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
I Upper Floors I
Garage Area
I Storage 7
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE NEW ❑ALT. 13 AD'N. E] RPL. El MVE.
7. OF El OTHER
WORK -1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK / Enum. Dist. Location (Area)
- FEES COLLECTED
8. t t / I <`—
wry
�11"'vim'-`
/ G���%
VALUATION
SOURCE
Fire Marshall
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
JGAS
UTILLITIES
(?�
TOTAL $ m7d
Public ❑Private C3
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
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performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SEPA Checklist
DATE OF APPLICATION 12 J SIGNATURE OF APPLICANT
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
) �� I� ,,���y�U
��� / 6oAd `o
Plan Check
Env. Health
2 �G
SEPA
Planning
/ IPERMIT NUMBER
SO 0
�i3* *33-,G0
*3'00
11 *Gv!J
481.3
6,h 79.
*33.00QCL'j -
wry
�11"'vim'-`
/ G���%
Mobile Home
--
�'t
4erVAp*etctfy)
Fire Marshall
Co. Engineer
1 K
:C
(?�
TOTAL $ m7d
Utilities
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
•1 2, 4'a 144
wilding hnician
*33.00QCL'j -