1980, 06-02 Permit: 80-5197 Sprinkler SystemPLAN 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 ADDRE S
2 /1 SOUTH "/ERCE
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
NER
3. SI R , oz 7Z'-A.tKO
AQpRESS
P61--7667
ZIP
PARCEL NUMBER/S
CONTRACTOR 11yr
psnio_P/J ��1 V / L"-11
4. D V6 r`o j'Y111�t11 TfM- �t
AD RESS IVb
nrozTH 5a 1 thrk81\
DESIGNER
5. ADDRESSSPime RC 7
P�iONE sr
Required Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
flcioic"
PHONE
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
8.
9.
kr NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH:
O RPL.
O M.H.
Source
of
Utilities
❑ MVE.
O POOL
‘21 turn
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 4031 FSb SIGNATURE
b
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) .3'
TOTAL $
G5*
51965
O6 -G2 -8O
6,479,
DATE(012'- OFFICIAL C1AJ
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
f 0 2- 3 '', •19, 7°
L.
X5,50