1980, 06-23 Permit: 80-6141 Plumbing FixturesPLAN NER
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
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LEGAL DESCRIPTION — SEE ATTACHED
1. ,
Source
GAS
LOT
BLOCK[SUBDIVISION
SEWER
9,
PARCEL NUMBER/S
2.
I
Single $
OWNER
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
PHONE
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
3
type of work will be complied with whether specified herein or not. The gr t g of a permit does not presume
°`�
c,r
to give authority to violate or cancel the provisions of any other state or c I regulating c struction or the "no -:50
Plumbing
ADDRESS
ys-
performance of construction.
ZIP
Required Set Backs in Feet
Mech.
North South
East West
CONTRA
PHONE
ize of Parcel
Zone Classification
IF J`••`D`"C�j/_�,(,
Planning
Mobile Home
4'
Co. Engineer Other (Specify)
Utilities
ADDRESS
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ZIP Q� /�/
Type Const.
Occupancy
Sprinklered
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Dyes []No ❑ Req'd.
DEStG1*E-R --7
P NE_
Valuation
Building Area in Sq. Ft.
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J
5.
ADD�E6S
ZI
DWL Area
Basement Area
Garage Area
Storage
i ,/� / i� �����
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE > MEW ❑ ALT. ❑ AD'N.
❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
❑ BLD. XPLMB. ❑ MECH:
❑ OTHER
❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
PERMIT NUMBER
`bD -(o i L4
DATE
DESCRIBE WORK
FEES COLLECTED
l
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9,
of
Utilities
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 gr t g of a permit does not presume
°`�
c,r
to give authority to violate or cancel the provisions of any other state or c I regulating c struction or the "no -:50
Plumbing
ys-
performance of construction.
DATE 2 [ SIGNATURE_ Zl
Mech.
SPECIAL APPROVALS SPECIAL DITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $�
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS{BECOMES A PERMIT.
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