1980, 01-15 Permit: 80-268 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT $v 2 b�
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
DESCRIBE WORK /�t , I
8 //,� � �1( FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, utilities
Single $
1 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 a t' Of a permit do not presume
to give authority to violate or cancel the provisions of any other state or oc regul con t uction or the —6 15
performance o connstr ctlon. Plumbing
DATE ! SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIALrjITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer L Other (Specify)
C z* *3C. 0
r I .i 1
*,G ;0
G67�
G
01 -1 5-30
6[x79,
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BEjCOMES�rA PERMIT.
DATE J---�--J�Y OFFICIAL X11!►AA
APPROVED FOR ISSUANCE
3�r C-
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
11 7X
LEGAL DESCRIPTION =ACHED
1
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
PHONE
3
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
1t 6 l
4'
ADDRES
ZIP
Type Const."
Sprinklered
;70!
❑Yes ❑No ❑ Req'd.
q�}
PHONE
Valuation
Building Area in Sq. Ft.
5
AD¢,
ZIP
DWL Area
Basement Area
Garage Area
Storage
0 . ooX
31
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE $,NEW
1:1ALT. ElAD'N. ElRPL.
ElMVE.
7.
OF
El BLD.
L�PLMB. ❑ MECH: ElM.H.
❑ OTHER
[IPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK /�t , I
8 //,� � �1( FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9, utilities
Single $
1 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 a t' Of a permit do not presume
to give authority to violate or cancel the provisions of any other state or oc regul con t uction or the —6 15
performance o connstr ctlon. Plumbing
DATE ! SIGNATURE_ Mech.
SPECIAL APPROVALS SPECIALrjITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer L Other (Specify)
C z* *3C. 0
r I .i 1
*,G ;0
G67�
G
01 -1 5-30
6[x79,
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BEjCOMES�rA PERMIT.
DATE J---�--J�Y OFFICIAL X11!►AA
APPROVED FOR ISSUANCE
3�r C-