1980, 01-21 Permit: 80-417 Plumbing FixturesPLAi4 NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL.
7, OF
ElWORK BLD. PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL CERTIFICATE Req'd. Recd. Not Rel
of EXEMPTION
DESCRIBE WORK
8 _ , IV I IF - ` FEES COLLECTED
VALUATION Source �GAS ELECTRIC WATER SEWER
of
j, 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 -4
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 1— G/ —610 SIGNATURE S
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE OFFICIAL, 4ALt�
APPROVED FOR ISSUANCE
Mobile Home
Other (Specify)
TOTAL $
PER
MIT NUMBER
DATE
03* *30,50
*3050
E *r0C,, U
41.6
01 -21 -80
;F 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
1
JOB AD RESSLEGAL
3
?
DESCRIPTION - SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
PHONE
3.
ADDRESS
ZIP
Required Set Backs in Feet
North South
East West
CONTRACTOR
PHOUE
Size of Parcel
Zone Classification
4'
ADDR S 1 �}
�r yCJi
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 Area
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.
7, OF
ElWORK BLD. PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL CERTIFICATE Req'd. Recd. Not Rel
of EXEMPTION
DESCRIBE WORK
8 _ , IV I IF - ` FEES COLLECTED
VALUATION Source �GAS ELECTRIC WATER SEWER
of
j, 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 -4
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 1— G/ —610 SIGNATURE S
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE OFFICIAL, 4ALt�
APPROVED FOR ISSUANCE
Mobile Home
Other (Specify)
TOTAL $
PER
MIT NUMBER
DATE
03* *30,50
*3050
E *r0C,, U
41.6
01 -21 -80
;F 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.