1980, 12-16 Permit: 80B-4910 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 3 COPIES
JOB ADDRESS
LOT BLOC SUBDIVISIO/e 7/4/-1
a�/r /lien
i
�
2.
LEGAL DESCRIPTION — SEE ATTACHED
3
4.
OWNER
laf23Tr4
WNST0.4-1-GTt ora
PHONE
ZS-Zf{4'8
PARCEL NUMBER/S
ADDRESS
Q //�/�}y�c/ ,. '�/-//p
CONT try•
�4'ld
ZI P
Actual Set Backs in Feet
North - ISouth [East West
PHONE
Size of Parcel I Zone Classification
ADDRESS
OESIGy
y
5. ADD// of
S
0 16%/19
CHANGE OF USE FROM
•
ZIP
PHONE /
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes -ONo 0 Req'd.
Valuation I Building Area in Sq. Ft.
Main Floor -
Upper Floors Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
OF
WORK
7§- NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
F. BLD. ITLPLMB. 0 MECH. 0 M.H. 0 POOL
r fix, fres
DESCRIBE WORK
8.
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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. SEE REVERSE SIDE FOR.REQUIRED INSPECTIONS
DATE OF APPLICATION r21/611/8C3 SIGNATURE OF APPLICANT
444 AC.readri.r/
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
2-0 • 3ar3z Sit
4- 'O4
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ildinp Techniciaann.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
. FEES COLLECTED
Single
Building
Plumbing 1/7/6�
' Mech.
Plan Check '
SEPA.
Mobile Home
Other (Specify)
TOTAL
70
03* *4800
*4800
*4800
A *000 0
49091
12-16-80
1 6479.
1,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
:111.,1
i„!16' :18 41910V. *4 & 0 0
PERMIT NO. TOTAL _
a. F