1980, 06-23 Permit: 80-6143 Plumbing FixturesPLAN NUM ER 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.
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER
1Z r
ADDRESS
4' ADDR
R
5.
A D DPES
CHANGE OF USE FROM TO
6.
PHONE
ZIP
Required Set Backs in Feet
North South East West
PHONE
Size of Parcel
Zone Classification
ZI
Type Const.
Occupancy
Sprinklered
/
06
❑Yes []No13Req'd.
PHONE
Valuation Building Area in Sq. Ft.
ZIP
7l/
DWL Area I Basement Area Garage Area Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
I YPE 76N.EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ALMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. I Rec'd77
of EXEMPTION
n DESCRIBE WORK // — , 1
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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. T nting of a permit does not presume
to give authority to violate or cancel the provisions of any other stat or I law re ating nstruction or the ��• `'"
performance f c/onstr ction. Plumbing G Z�SP
DATE ` SIGNATURE Mech.
SPECIAL APPROVALS SPECT NDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $ �/
Zone Clearance
WHEN MACHINE VALIDAT
SEPA ChecklistTHIS BECOMES A PERMIT.
t
.. ,. , .. ,.. DATE �i+/aFFICIAL _ _�.;„^/�/'V�1�� CJ '(.. 2
PERMIT NUMBER
DATE
E n-
61G2-,"
06 -GJ -80
6/-79.
N THIS SPACE, S