1980, 03-10 Permit: 80-1944 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 ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
SourceGAS
of
Utilities
ELECTRIC
WATER
SEWER
WNER
P�c�l�'i,
PHONE
3.
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
y
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
ADDRESS
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ZIP
Required Set Backs in Feet
f _
Plumbing
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North South
East West
CONTRACTOR
lam►
DATE /a SIGNATURE <
PHONE
Size of Parcel
Zone Classification
PIuv-,hj,,7p. . ,�:,v'
4.
l -s,1//
Plan Check
Sprinklered
ADDRESS %�' _ //. [/_
/
ZIP C
Type Const. Occupancy
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
0—
Mobile Home
Mobile
5. ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Utilities
Split Entry
Split
Level
Rancher
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist
THIS A PRMIT.
I(�Jt
_Z U Q n F
i n *28,0 t,'
dAL
�`C L
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE .NEW ❑ ALT. ElAD'N. EIRPL.
ElMVE.
7, OF
❑ BLD. -kPLMB. ❑ MECH: ElM.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WOUK
8 r� gl `'
FEES COLLECTED
PERMIT N'aIMBER
'700P -�
03* *2800
*28.00 C
*28.00
E *0.00 00
1943
-W-0-80
2 6:479,
VALUATICIN
9,
SourceGAS
of
Utilities
ELECTRIC
WATER
SEWER
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
y
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
�U
�G���`�•, ��
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
— �t7 ����z
DATE /a SIGNATURE <
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Plan Check
Env. Health f"
ry_
SEPA
�J
Planning
0—
Mobile Home
Mobile
Fire Marshall
—
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist
THIS A PRMIT.
I(�Jt
_Z U Q n F
i n *28,0 t,'
dAL
�`C L
DATE OFFI I
APPROVES ISSUANCE
—�D
—