1980, 06-26 Permit: 80-6343 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
E. 4307 - tth
LOT
BLOCK
SUBDIVISION
OWNER
H. Gordon Churchill
PHONE
534-8854
LEGAL DESCRIPTION — SEE ATTACHED
PAROL NUMBER/S
AD RE
�. 4 44 - 5th, Spokane, Wash.
ZIP
99203
4.
CONTRACTOR
Miller's Plumbing
ADrE 3 Liberty, Spokane, Wash.
PHONE
483-2025
Actual Set Backs in Feet
North 'South [East IWest
Size of Parcel
Zone Classification
zip 9207
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
/1/S NEW
❑ BLD.
D� ALT.
jj(
`173 PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
s. 401W- Plumbing Installation
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
9.
WATER
Enum. Dist.
ILocation (Area)
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 6-25-80 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
15 Fixtures @ $2.50 ea. + $3.00 permit fee = $40.50
NOTE: Please inspect rough -in installation on the
afternoon of Thursday, June 26, 1980.
Thank you, David & Rosie Miller
Miller's Plumbing
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
37.50
Otllieere(Specify) 3.00
TOTAL
$ 40.50
PERMIT NUMBER
03* *4Q50
*40.50
*40506
B *0.00 E
634,28
06-26-80
g 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
uo-2,6`-8'0
DATE ISSUED
634,3 *40.50°
PERMIT NO. TOTAL