1980, 01-04 Permit: 81A-9822 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
FEES COLLECTED
8. . ,.C�+.�C.1
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
performance of construction. > Plumbing�--
DATE ,/- l&—* ' SIGNATURE e�2 � r Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. oi� r tia
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
3 WL
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Fa
JOB ADDRESS1
k
LEGAL DESCRIPTION — SEE ATTACHED
714/
f
n
l
blb�?Cu14$XL�•IL'
LO
-BLOCK
SUBDIVISION
PARCEL NUMBER/S
2.
WNER '
PHONE
Cr
3
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CON RACT R
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIP
Type Const.
Sprinklered
,•
/32-
_,/
O•J
z
P./
TOccupancy
❑Yes []No 1:1 Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Ar;77
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE E –M -EW
❑ ALT.
❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF,-,��
1:1 BLD.
4H!LMB.
ElMECH: 1:1M.H.
El OTHER
El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8. . ,.C�+.�C.1
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
performance of construction. > Plumbing�--
DATE ,/- l&—* ' SIGNATURE e�2 � r Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. oi� r tia
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
3 WL
Fa
f
n
l
blb�?Cu14$XL�•IL'
DATE OFFICIAL
APPROVED FOR ISSUANCE
SEPA
Mobile Home
� pu
Other (SI5eci y)
TOTAL $ E7n
(j PERMIT NUMBER °
DATE % �(,�—D
*38,00_`
E * G.
9821
01-04-'0
22 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 4 -Pi G