HomeMy WebLinkAbout1980, 05-20 Permit: 80-2435 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
P-$0 -a te
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1.
/a7 Ail 4,1 0 e'erJe
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. Ti �U��)6)6?1� �R'
ADDRESS
CONTRAC
4. ADD
DESIGNER
5. ADDRESS
D
4fit/tied-e,ele-
PRE// "
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Valuation
East 'West
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area ( Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
9.
TO
Split Entry
Split Level
Rancher
NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
PLMB.
0 MECH: 0 M.H. ❑ POOL
Source
of
Utilities
' A -CA -4)
GAS
0 OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 laws and ordinances governing this
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
FOR GAS:
PIPE SIZES:
PIPE LENGTHS:
BTU'S:
DATE3Id1JI )OFFICI AI
4;k%H
CtfYVYtC5Y‘
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
5 `I
0 L.
2 3.L
(J L• -2C- '.0
6 l; i 9
WHEN MACHINE VALIDATED iN THIS SPACE,
THIS BECOMES A PERMIT.