1980, 04-02 Permit: 80-3006 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 4 COPIES
JOB ADDRESS i-- •�
1.
C 1 � C� ! • X41 Lj;ed) �lYt-I LEGAL DESCRIPTION — SEE ATTACHED
PERMIT NUMBER
P 8a -avow
DATE * --Z
3 1
6,479.
8. r I FEES COLLECTED
OWNER 0 ^ �
2 --C.4 Ivu.J.er�ch
✓
PHONE
Source
GAS
3.
vV V
SEWER
Q
of
Utilities
ADDRESS
ZIP
Required Set Backs in Feet
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 permi does not presume
to give authority to violate or cancel the provisions of any other state r to I law regulating nstruction or the 3
North South
East West
ruction.
DATE SIGNATURE_ Mech.
CONTRA T R
PECIAL APPROVALS SPECIAL CONDIT NS:
PHONE
Size of Parcel
Zone Classification
4'
SEPA
Planning
126
Fire Marshall Mobiles Home
Co. Engineer Other (Specify) J,UV
A RESS
ZIP
Type Const.
Occupancy
Sprinklered
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
_ THIS BECOMES A PERMIT.
SEPA Checklist c� r
_ a u
�"
* `v
DATE OFFICIAI �; 1; " ?i L'
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
OWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE 1:1 NEW
GALT.
ElAD'N. El RPL.
1:1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7
El OTHER
El BLD.
�,PLMB.
ElMECH: ElM.H.
El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
PERMIT NUMBER
P 8a -avow
DATE * --Z
3 1
6,479.
8. r I FEES COLLECTED
2 --C.4 Ivu.J.er�ch
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9.
of
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 permi does not presume
to give authority to violate or cancel the provisions of any other state r to I law regulating nstruction or the 3
Plumbing �0
performance of ons
ruction.
DATE SIGNATURE_ Mech.
PECIAL APPROVALS SPECIAL CONDIT NS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobiles Home
Co. Engineer Other (Specify) J,UV
Utilities
TOTAL $ o V
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
_ THIS BECOMES A PERMIT.
SEPA Checklist c� r
_ a u
�"
* `v
DATE OFFICIAI �; 1; " ?i L'
J i;_ 11 �vi �'