1980, 04-30 Permit: 80-4113 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PER Mit-NUMBER
SPOKANE COUNTY BUILDING CODES DEPARTMENT .' •a' -3
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 7 '
J a (�
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 7 O3 * * 105O
1 LEGAL DESCRIPTION - SEE ATTACHED Q .r 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1
2. * 1O..50
OWNER PHONE .. E * f` O ., r}
3
t S�`�N 60-7t.cc f 5 ' 715'6
ADDRESS // Z / Required Set Backs in Feet G. 1 1.2
S/�j07 Cj Fl//l I/c4�! te a V7 2-[ j North 'South
CONTRACTO PHONE Size of Parcel EZotne Classificato
0 - 30—8
0
7-7.3-.r7' AE le-4-19rrSE'c - - vyt 92'-l42 6479.•.
4. ADDRESS ZIP Type Const. Occupancy 'West
Sprinklered
fV 2.1 e ` ;21 ' 5-:--1--- 9'/20b
Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No. Baths No. Floors No. Rooms Rec. Room
❑ NEW ❑ ALT. AD'N. ❑ RPL. ❑ MVE.
7, OF Cl OTHER -
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ElM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
3 i FEES COLLECTED
8. 11s.QA
VALUATION Source AS 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 , a permit .•oe• of p - ume
to give authority to violate or cancel the provisions of any other state or I. al la , •gu)ating co t ction or the 7 (a
performance of construction. Plumbing O'
DATEZ_ v a SIGNATURE u = • Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health / — 7-0 i le 4-
G SEPA (—
Planning I J _ w
l
l 6A- Mobile Home z
Fire Marshall
Co. Engineer Other (Speci y) 3•d U
Utilities (/�
TOTAL $ /0/ Ji/
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS
"�BECOMESAPERMIT. r
DATE��OFFICIAL 0l4 3 0'-8 0 4'11. 3 * 1 0.5 0 8.. 1:i-
APPROVED
JAPPROVED FOR ISSUANCE
-