1980, 05-09 Permit: 80-4508 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESSSEE ATTACHED
// LEGAL DESCRIPTION —
,. ,qc� �- _ f,�
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
OWNER
PHONE
ADDRESS
^'
ZIP
Required Set Backs in Feet
J
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑
Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
DWL Area
Basement Area
Garage Ar;7
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF OTHER
BLD. LMB. E]MECH: ❑ M.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK �� ' �/
/ /V E- FEES COLLECTED
8.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 granting of a permit does not presume i1 '(4,
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the Plumbing �•ry
performance of rconstruction.
DATE / 'SSIGNATURE
SIGNATURE �T�` r ' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE) Q� OFFICIAL &"
APPROVED MRSSUANCE
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
04* *30.50
*30.50 N
*3Q50�
E *0.00
450,72
05-0-80
2 61479.
wk,
TOTAL $ • O•Sa
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COM APERMIT.
{�80 450.82
*3Q50°a,-'