1980, 05-05 Permit: 80-4314 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. � � u I �, AP. eI) 0 1' J P LEGAL DESCRIPTION -SEE ATTACHED
PERMIT NUMBER
DATE — Z
* 00
*�3 0
11,31-9
0 5—U r-''."� U
b17�
VALUATION
OWN
� e
ELECTRIC
WATER
PHONE
3.
of
Utilities
Single $
AD ESS
ZIP
Required Set Backs in Feet
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
C
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
G
performance of construction.
Plumbing
DATE SIGNATURE—
North South
East West
SPECIAL APPROVALS
CONTRACTOR
DEPT. REQ'D. RECD.
PHONE
Size of Parcel
Zone Classification
Env. Health
SEPA
4'
Mobile Home
Fire Marshall
ADORES
Co. Engineer
ZIP
Type Const.
Occupancy
Sprinklered
�
.(. 6 7
Utilities
❑Yes []No ❑ Req'd.
DESIGNER
Zone Clearance
PHONE
Valuation
Building Area in Sq. Ft.
5.
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS COME$ A PERMIT.
�`( '5k
0 7 —
DATE `- OFFICIAL A"
'� ` % '�' r
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW
❑ALT.
1-1 AD -N.
El RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
❑ BLD.
Dk PLMB.
❑ MECH;
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
8
S
FEES COLLECTED
PERMIT NUMBER
DATE — Z
* 00
*�3 0
11,31-9
0 5—U r-''."� U
b17�
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 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.
Plumbing
DATE SIGNATURE—
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities
..'7
TOTAL $,IS -6
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS COME$ A PERMIT.
�`( '5k
0 7 —
DATE `- OFFICIAL A"
'� ` % '�' r
* 3. Ul `n d F-