1980, 06-13 Permit: 80-5768 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1I nT I I I PARCEL NUMBER/S
PERMIT NUMBER
Ps -
DATE
L * 0
576,7
06-1 3-80
.6. L, 7 9.
TYPE "NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER CERTIFICATE Req'd. I Recd. Not Req'd.
WORK ❑ BLD. XPLMB.
El ❑ M.H. ElPOOL
of EXEMPTION
DESCRIBE WORK 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 ra ting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or regulating nstruction or the Plumbing
performance
of construction.
DATE sQ(�J SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL C N ITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS B(�ECOMES A PERMIT. -
DATECj�' / OFFICIAL f' 1/1A/yln'TL,� 1 J li
W7S
APPROVED FOR ISSUANCE
OWNER
PHONE
3•
ZIP
Required Set Backs
in Feet
ADDRESS
North
South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Leo
4.
ZIP
Type Const.
Occupancy
Sprinklered
ADDR 55
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
' J9.
99-1-114
5.
ZIB,
DWL Area
Basement Area
Garage Area Storage
ADD ESS
ItO
_
CHANGE OF USE FROM TO
Split Entry
Split
Level Rancher
6
No Baths
No Floors
No Rooms Rec. Room
PERMIT NUMBER
Ps -
DATE
L * 0
576,7
06-1 3-80
.6. L, 7 9.
TYPE "NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER CERTIFICATE Req'd. I Recd. Not Req'd.
WORK ❑ BLD. XPLMB.
El ❑ M.H. ElPOOL
of EXEMPTION
DESCRIBE WORK 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 ra ting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or regulating nstruction or the Plumbing
performance
of construction.
DATE sQ(�J SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL C N ITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS B(�ECOMES A PERMIT. -
DATECj�' / OFFICIAL f' 1/1A/yln'TL,� 1 J li
W7S
APPROVED FOR ISSUANCE