1980, 12-29 Permit: 80B-5252 Plumbing Fixtures PLAN NUMBER I APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT t gL3 `�,5
_ ,
e...) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
03 * * 4300
JOB ADDRESS
1. 17 PI .5 � era, (mat.
LEGAL DESCRIPTION — SEE ATTACHED * 4 3.0 d N
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 4 3 d 0
2.
0/SIE P ONE A * 0, 0 0 8
3 ADDRESS �arrl SNIZIP � NS-4Actual Set Backs in Feet 5 2 5. 1
/V ' 5 3_19 SULU UAW North 'SouthEast 'West 1 2—2 9—8 0
CONTRACTOR PHONE Size of Parcel Zone Classification
`T J •.13 , Vfl Ec,ft . 9',; i3-901i). 2 6 4 7 9.
4. ADDRESS ZIPType Const. Occupancy Sprinklered
UIt,O''7I 1�C - l T rzENT C/%'4 Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE .NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF bbb ❑ OTHER
WORK ❑ BLD. .PLMB. El MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Dist. I Location (Area) '
8. Ply
j0 T
PIN FEES COLLECTED
VALUATION Y �
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private 0
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECT! S Plumbing A10.eco
1 d d , d '� � Mech.
DATE OF APPLICATION /o`� /� SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health D
�N,.�C SEPA (z
Planning _�r✓ `� w ' s j
Fire Marshall
40i Os 1 C. A A . Mobile Home .-
i
3 (1v5
Co. Engineer I b X 'SI)— her(Specify) 3
Utilities I (• S
I a TOTAL $ 043-
Plans Examiner
WHEN MACHINE
VALIDA
SEPA Checklist
OI Is, • THIS BECOMES A PERM IT. IN THIS SPACE,
Buildin T icia I I 1'• PERMIT IS NONTRANSFERABLE t A'.
1 2 �2 9. ,$10' ,2 d *4 33 U C F-
a -
, k „ rA-4/a24� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL