1980, 03-13 Permit: 80-2160 Plumbing Fixtures PLAN NUMBER PERMIT NUMBER I
APPLICATION/PERMIT /moo
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS n3 * * 28,00
1. LOCK SUBDIVISION/I �ee�j LEGAL DESCRIPTION — SEE ATTACHED * C r
LOT LOCK SUBDIVISION PARCEL NUMBER/S
2.
* 28. 10`
OiViER PHONEE .*. Cf;
3. Ai t
ADDRESS ZIP Required Set Backs in Feet 2 1 5.9 G
North 'South East 'West 0 o
CONT A TOtten /� PHONE Size of Parcel Zone Classification 3— 1 3—81
a. �C/LL j� 6 4 7 9,
A RES ^ L �' Wa9/ Type Const. Occupancy Sprinklered
//j% �_(J ❑Yes ❑No ❑ Req'd.
D SIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE $ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK LI BLD. ❑ PLMB. ❑ MECH: D M.H. ❑ POOL
of EXEMPTION
•
DESCRIBE WORK
8. / 0 n ‘,61(4.0e.> FEES COLLECTED
T
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
Single $
—
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 o laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The gr.nting of a per it does not presume
to give authority to violate or cancel the provisions of any other stater lo.:l law regulati g cons ruction or the /0 .()U
performanof c ,nssttrruction. Plumbing
DATE N3 / / / SIGNATURE �_ / Mech.
SPECIAL APPROVALS SPECIAL CON•ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health
cti
SEPA O
Planning v
_ w
e 2
Mobile Home cc)
Fire Marshall
• 3 u 3 ').-'
Co. Engineer + Other (Specify)
Utilities TOTAL $ag 02
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,$ COMErS A RE,RMIT. -.
SEPA Checklist IIIILWItie/� I, t. i.. i A U s U I ,t
DATE 7 / v-3 OF IAS' ., _ _- __
A—if D FOR ISSUANCE _