1980, 01-09 Permit: 80A-9967 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT D-A- c1�_7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS V7/ 4 67/J( L ^ /! n �� * * 6 a, `�
1�/l LEGAL DESCRIPTION - SEE ATTACHED 111 �� (�� `-
1 LOT BLOCK SUBDIVISION PARCEL NUMBER/S 6 �'
2. E * 0,00 t
OWNER PHONE
3. 9966-
ADDRESS ZIP Required Set Backs in Feet
North 'South East IWest 0 1 —0 9-8 0
CONTRACTO??4, /I P ONE Size of Parcel Zone Classification L.7 9.
4' ADDRESS/t1 .Lt1 !-- ZIP y4 / Type Const. Occupancy Sprinklered
ti 26, Cr L�Yt' f 1 T P` , ! lQ i? ❑Yes ❑No ❑ Req'd.
DCCi91VCr2 ��. ����E Valuation Building Area in Sq. Ft.
5. ADD S., 'efY V, � ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF U E FROM TO Split Entry Split Level Rancher
6.
TYPENo. Baths No. Floors No. Rooms Rec. Room
NEW El ALT. ❑ AD'N. ❑ RPL. El MVE.
7, OF ❑ OTHER
WORK IIIBLD. ❑ PLMB. 1:1MECH: I=1M.H. ClPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Ll
8 / / x -a rC S FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER i
of
9. Utilities
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 ,, .‘al law re latin onstruction or the
performance of cons ruction.
Plumbing
DATE f /r' " 'V�/ SIGNATURE `111
Mech.
SPECIAL APPROVALS SPECIAL C4N r ITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
Planning v
— w
a.
Mobile Home vi
Fire Marshall z
Co. Engineer Other (Specify) / ,
Utilities TOTAL $ vj
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. 7 * 6 5 t^ 1,� O {2
illa2k-r (..!
�f j r) n �: �� _DATE "� l00FFICIAL � ,J -
APPROVED FOR ISSUANCE