1980, 12-17 Permit: 80B-4989 Plumbing Fixtures,(PLAN 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
JOB ADDRESS
LOT
BLOC SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
O NE
3.% ADDRESS
old ./ 92,
PHONE
CCONTRACTOR4. n •
/%
ADDRESS/'
/ / Q
DESIGNER
PHONE
1 Dyl'e57S
ZIP
Actual Set Backs in Feet
North (South East Wes
Size of Parcel
Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
X PLMB.
PHONE
ZIP
TO
❑ AD'N.
O MECH.
❑ RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
Valuation Building Area in Sq. Ft.
Main Floor
Upper Floors Garage Area
Storage
Area of Decks
Finished Basemen
Un in. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ZSCRIBEOR
8. L
9.
LUATIONSOURCE
OF
UTILITIES
GAS
EL
ELEC R C
WATER
TLC—AL
SEWER
Enum. Dist. 1 Location (Area)
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 INSPECTIO
DATE OF APPLICATION iZ — / 7-k a
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B�yjldin Tec me
wl
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
47 cli
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
YOB)
- PEiF1VIIT NUMBER
ge13-4195
03* *8.00
*800
*8006
A *000
49888
12-17-80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
49&95 48,00°ae
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL