1980, 06-17 Permit: 80-5880 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT `-z-1,) %0
' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB/ADDRESS1 LEGAL DESCRIPTION — SEE ATTACHED 0 3 * * 3 3.0 0
1
LOT !!//[[����////' ���BLOCK SUBDIVISION Yv`'� PARCEL NUMBER/S * 3 3.0 0
2.
(( A� CO ! ( * 33.00,,
3
OWNER
,J n/"/ Cly)Ac Ai ee Ae f PHONE E * 0.0 0
ADDRESS ZIP Actual Set Backs in Feet
North 'South East 'West 5 8 7,9 0
CONTRACTOR/ P NE Size of Parcel Zone Classification
a T- J.. / - At f-r -7)J%'s c s 4=,A(c._. 2 -�1'�?�/zL 0 6- 1 7-8 0
ADDRESS /i / 1 ZIP 7 ,�. Type Const. Occupancy Sprinklered 6,a'7 9,
it&a 5- .. * ke-- "'C 79'L_L:iL' ❑Yes ONO ❑ 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.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER -
WORK I=1 [BLD. PLMB. ❑ MECH. 0 M.H. CIPOOL - CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 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 ordinanc• :., fling this
type of work will be complied with whether specified herein or not. The granting of a .:es' et presume' Building
to give authority to violate or cancel the provisions of any other state or local I. •ulatinf'`co uctien or the ,ry
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECT'! I Plumbing .30,al
2 41011111.7
DATE OF APPLICATION "' ' / SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
(/�A g�l
^/� _ �'f \r
2i .r SEPA i
Planning / [� -
Fire Marshall Mobile Home -
i
Co. Engineer O er(Speci y) ,cit
Z
Utilities /�
TOTAL $ c.53 i 6
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Ilkingphician PERMIT IS NONTRANSFERABLE 0 61i-117 —8 0 5 8 8, 0 z *3 3, 0 0 2 Ili-1,r‘,..,,,'4^c-',,'f,,) PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL