1980, 06-12 Permit: 80-5699 Plumbing Fixtures s r w.
PLAN N MBER APPLICATION/PERMIT PERMIT NUMBER 1
'r<-- SPOKANE COUNTY — BUILDING CODES DEPARTMENT # P---c60- 69C1
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES * 2 5 5 0
JOB ADDRESS .4 LEGAL DESCRIPTION - SEE ATTACHED * 2 5 5 0 c~n
1. c- - /.� / 7 // �{
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 2 5.5 0 6
2.
OWNER /� PHONE E *O,0 0 O
3. � <� � , v . 9=1 /-C,i 569,8
ADDRESS / �� ZIP Required Set Backs in Feet
....—q- --'S.rz /-�s C_.lY2a�C'lpt L?�L.c-u,i, S re-'r6 North 'South East 1West 0 6— 1 2—8 0
CONTRACTOR /> PHONE Size of Parcel Zone Classification
_ /I_ ((17, 1 c�r/L `.t, 4(-..z�.ol- r 6479.
4' ADD SS //�}Cf� ZIP Type Const. Occupancy Sprinklered
. ,-Zi Ci 'i.
�/ /.ae . - 9,Ce'.7 7 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE IW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF „—.-,,IL���--
'PLMB. El❑ BLD. OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK El ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK _ i
8. "-,7”- Ai' -Ga4—, FEES COLLECTED
VALUATION Source ( GAS ELECTRIC WATER SEWER
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 or local law regulating construction or the .1_,S7 SO
Plumbing
performance o
c� nstruction.
DATE � �� �/ SIGNATURE/1W41
4-*4
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA o
I—
Planning — w
a_
Mobile Home cn
Fire Marshall Z
Co. Engineer Other (Specify)
Utilities TOTAL $ S 2----
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist //ll4.: 71THIS BECOMES A PERMIT.
DATE 4*OFFICIAL b1A 6-12 `8'0 5 6 9.9 z 2 5.5 a I-
APPROVED FOR ISSUANCE —