1980, 09-25 Permit: 80B-890 Plumbing Fixtures PLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
` SPOKANE COUNTY - BUILDING CODES DEPARTMENT P &D Sq0
/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESSn
1 �3.� �- LEGAL DESCRIPTION - SEE ATTACHED C 3 * * 2 �. 0 0
LOT BLOCK SUBDIVI ION PARCEL NUMBER/S * 2 2 0
2. PHONE * 2 r 0 0
3. �1% ---e) A * 0 0
ADDRESS ZIP Actual Set Backs in Feet
GP P_`
North 'South East West
CONTR TOR PHONE Size of Parcel Zone Classification
4.
ADDSy�- ZI Type Const. Occupancy Sprinklered 6 [(7 9
/32-41`3 L.�i 9c,2-�� ❑Yes ❑No 0 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.
TYPE �� No. Baths No. Stories No. Rooms No. of Dwellings
'C] NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF •�-I� ❑ OTHER
WORK
0 BLD. fdP'LMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK ' Enum. Dist. I Location (Area)
8 y0G� �/�, 4 FEES COLLECTED *
VALUATION /
SOURCE 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 ordinances governing this Building
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 ,� Plumbing Z Q�
DATE OF APPLICATION r/2,..1Av SIGNATURE OF APPLICANT �E/ ZC.� 6,.d, -' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health of Ce)[/ SEPA a...
Planning O
r U
!- D Mobile Home w
Fire Marshall CC `J
Co. Engineer i ,1 Other (Specify)
11-
Utilities / CO tiI
TOTAL $ Gid
Plans Examiner / 4
OCal it.
N�� WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / 4 te.mi U• THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE `C '� h`2 S"` `O 8 9. 0 z * 2 8. 0 0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL