1980, 09-22 Permit: 80B-0617 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMITn PERMIT NUMBER I
t SPOKANE COUNTY — BUILDING CODES DEPARTMENT �" 0 ,17
�� NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
111 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES , ;,- .
JOB ADD. ESS _ ....
1. 6- As/.,24 ~ /67.2.2 Crs LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S C'
2. r' /* _
OWNS PHONE
3. lUrsoLJ *44"iit'
?a51-//09
ADDRESSZIP Required Set Backs in Feet
.,fir 7 ;4/4 North 'South East West - L. — ' 0
CONT A TOR PHONE Size of Parcel Zone Classification 7 c,
•y.Zloa� 6 L. . ,.
4' ADD S � e ZIP Type Const. Occupancy Sprinklered�3 Y�. X903 7 ❑Yes ❑No ❑ Req'd.
DESIGNER 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 l , NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF £�/ . ❑ ID OTHER
WORK ❑ BLD. PLMBMECH: M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. �{i %V�///f e ��/' g�^G . /f
FEES COLLECTED
VALUATION Source GA 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 of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume oG
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance f cons ction. �� Plumbing
DATE / / 41/151SIGNATURE/��%` Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health ci
SEPA cp
o
Planning v
w
0_
Mobile Home c.o
Fire Marshall z
Co. Engineer Other (Specify)
Utilitiesfilet,
TOTAL $ le
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / s THIS BECOMES A PERMIT.
s7 C.�
DATE/�'f'�OFF AL - _ / L!
APPROVED FOR ISSUANCE -