1980, 09-18 Permit: 80B-421 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 3 COPIES
1.
2.
3
JOB ADDRESS
C. / ZOOG -7-14
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
4.
OWNER
+5271/E4.O0V
ADDRESS
6. tzcpcpc.‚c'
CONTRACTOR
?Go Sreir'rzc. ?cac, € terry
V,4,, 67ra.1.)
ADDRESS
.3olg - /1-8/`I
DESIGNER
PHONE
ZIP
9'?zoc.
PHONE
3w '44-
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
East 'West
Zone Classification
ZI P
99zc>S,
PHONE
Type Const.
Occupancy
Sprinklered
Elves ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
5' ADDRESS
ZI P
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Main Floor
Upper Floors I Garage Area
Area of Decks
Finished Basement
Storage
Unfin. Basement
g" -NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
EI OTHER
❑ BLD. 1YrPLMB. ❑ MECH. ❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. 2 Fix 7-c426
9.
VALUATION
SOURCE
OF
UTILITIES
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
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 INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B di Technician
f.. 91i6s
SIGNATURE OF APPLICANT
SPECIAL CONbITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$ O C
TOTAL $
PERMIT NUMBER
@o; - z 1
03* *800
*B00
4202
09-18-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09.1$ 80 42.12
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
*0.011 a.F-