1980, 06-05 Permit: 80-5414 Range, PipingPLAN NUMBER
1 W it
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
JOB ADDRESS
,.1110{15-'111C
se
LO IBL CK ■BD VI
2.
r. LEGAL DESCRIPTION - SEE ATTACHED
ON
PARCEL NUMBER/S
OWNER
3
[SAD ,(�/
f. gcc -
CSO TRACTOR
ADDRESS
e. /o4/48 Ax. ax.fic pct
DESIGNER
4.
5.
PHONE
gz-0-9540'7
ZIP
ggtobo
Actual Set Backs -in Feet
North 'South
East
'West
PHONE
92 - 7087
Size of Parcel Zone Classification
ZIP //
9g.1-=-06°
Type Const.
Occupancy
Sprinklered
Oyes DNo 0 Req'd.
PHONE
Valuation I Building Area in Sq. Ft.
ADDRESS
21P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
-Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
O NEW
O BLD.
O ALT.
O PLMB.
0 AD N.
Al MECH.
O RPL.
❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of -Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ESCRIBE ORK
8. d. .iAL/I
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRI
WATER
SEWER
Ownership
Public O Private 0
USE CODE
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
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS •
DATE OF APPLICATION L -�'��
SIGNATURE OF APPLICANT.*
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
Budin• Te nicianf
/ /
1 .,i .e
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Of oG
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ b
6,0
PERMIT NUMBER
04* *400
*600 17)
*400ffi
*Q00
541.3A
06=05=80
_ A 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0 :'o,. 5, 0
DATE ISSUED 81
5'4145
PERMIT NO.
*6,00'2
TOTAL
Ls.