1980, 11-12 Permit: P80B-3565 Plumbing FixturesPLAN NUMBER
JOB ADDRESS
1.
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKPNE, WA: HINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
N.
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
ADDRESS
r r
13.0y / 373 2-3
CONTRACTOR
Ai\ I 13/ ���
4. ADDRESS ( j/ _J
PHONE
PARCEL NUMBER/S
ZI P
Actual Set Backs in Feet
North !South LEast 'West
DESIGNER
5' ADDRESS
PHONE
`i'l 5-39')/
Size of Parcel I Zone Classification
ZIP
/44-04
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
EW ❑ ALT. ❑ AD'N. 0 RPL. ❑ MVE.
dO BLD. WPLMB. 0 MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WO K
8.!f f€ rcG(2 * /% 7/.t' /ev
9.
VALUATION
SOURCE
OF
UTILITIES
GAS
/(4:6,-) /44'iv
Enum. Dist.
ILocation (Area)
ELECTRIC
WATER
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 L/"—le V)
SIGNATURE OF APPLICANT���"` /' 4�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing a7 6re
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
8013-356c
03* *30.00
*3000 N
*30006
A *0.00
3564
1`i-12-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
41(472978'0 3,5652 *30.00a�
PERMIT NO. TOTAL
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED