1980, 07-11 Permit: 80-6971 Plumbing Fixtures APPLICATION/PERMIT �7�
PLAN NUMBER ,.�- P PERMIT���
SPOKANE COUNTY — BUILDING CODES DEPARTMENT SV
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
G
/,y�JO�'B ADDRESS //'��) LEGAL DESCRIPTION - SEE ATTACHED 0 3 * * 2� 0
1 LOT �,�K IVISN�� ��� PARCEL NUMBER/S * 2 5 0 N
2. T �i .pj �`jc. ,'/ . '-6Co#9 * 2 5,5 0
OWN R i PH NEE * P
4„,,,t7e.A., ,,,,,,,,,,,,
ADDRE �ZIyP
Required Set Backs in Feet 6 9 6 8§.
-/�SJS-- .6,'i /.9 e-)6 North 'South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification 0 7- 1 1 -8 0
6,..9 /'-5 .J-5/.,,-�rr 9 l�-1 Sal".l
4' ADDRESS (/ Type Const. Occupancy Sprinklered 6 4 7 9.
/J T Z P
SQ l�t2i 444-2e- 49 ❑Yes ❑No ❑ Req'd.
DESIGNER //7 /� 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.
TYPE No. Baths No. Floors No. Rooms Rec. Room
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF OTHER -
WORK El �/BLD. PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK FEES COLLECTED •
8. ? F/X7.0.€(
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 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
to give authority to violate or cancel the provisions of any other state or loc. law regulating construction or the 2.c, V
Plumbing ing
performance of construction.
DATE /l — SIGNATURE ---,: e/ f'
i Mech.
'ECIAL
APPROVALS SPECIAL CONDI • S: /
DEPT. REQ'D. REC'D. Plan Check
Env. Health ce
SEPA o
_-
Planning — w
0
Mobile Home rn
Fire Marshall —
Co. Engineer Other(Specify)
Utilities TOTAL $ mss• 'co
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /�/ 9/7
THIS B�7ECOMES A PERMIT. l [DATE Il"7c^' OFFICIAL 5-' 0 / i�..(.�,, 8.0 6 9 2 1 - * 2 1. 5 0 2 f
APPROVED FOR ISSUANCE _