1980, 12-16 Permit: 80B-4922 Plumbing FixturesPLAN NUMBER
Lk/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOC
K SLBDI 10
OWN
ESS
. /O/26b s
r%%.I
DDRESS
PHONE 7
9,z,P �/ 9
ZIP
p2-106
457- '76
ADD S jer ,d
41/At/Ye Of
CHANGE OF USE FROM
6.
PHONE
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East (West
Zone Classification
Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Building Area In Sq. Ft.
Upper Floors Garage Area Storage
Size of Parcel
Type Const.
Valuation
Main Floor
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE i NEW 0 ALT.
7. OF �"'
WORK 19,40(//kPLM B.
DESCRIBE WORK
8.
VALUATION
9.
0 AD N. 0 RPL. 0 MVE.
0 MECH. 0 M.H. 0 POOL
SOURCE GAS
OF
UTILITIES
/ 9/P
I$
ELECTRIC r WATER
0 OTHER
SEWER
No. Baths ,
NO. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
OwnershIP
Public 0 Private 0
Location (Area)
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 72/67 /o SIGNATURE OF APPLICANT
SPECIAL APPROVALS
. NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engmee
Utilities ,
Plans Examiner
SEPA Check
SPECIAL CONDITIONS:
Id ng
cs f}Gi' Sitter`
�
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify/
TOTAL
St;,.
$ i\"/ %1 .�
�n PERMIT NUMBER
Y pig__ 42-2
03* *4800
*4800
*48006
A " *000 8
492'12
12-16-80
2 6.479
Zr
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
49Z2'Z' *4&002 -
PERMIT NO. TOTAL