1980, 06-23 Permit P-80-6135 Plumbing FixturesPLAN NUM ER
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 f,
4/ala -IP-•,v2
LOT BLOCK SUBDIVISION
OWNER
ADDRESS
CONTRACTOR
4. b14.--/r tip r ;se('
AD RESS
r01-3
ADDpS . Ox
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
ZIP /'
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North
Size of Parcel
South
Type Const.
Valuation
Occupancy
DWL Area I Basement Area
Split Ent
y
East
Zone
West
Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
TYPE
7. OF
WO RK
JEW ❑ ALT. 0 AD N. 0 RPL. ❑ MVE.
❑ BLD. ORLMB. ❑ MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATION
9.
Source GAS
of
Utilities
7L) 3
ELECTRIC
WATER
SEWER
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
type of work will be complied with whether specified herein or not. Th: 1r. ting of a permit does not presume
to give authority to violate or cancel the provisions of any other state ► law r•=..tin onstruction or the
performance o constr ti
DATE Z7 /? �.
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE far/I 4.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIA
i
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL.
PERMIT NUMBER
P7,o-1�5
DATE
$ 3../-' 50
03* *3550
*3550 I
*35506
E *Q00 8
6134i
06-23-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
FFICIAL
APPROVED FOR ISSUANCE
b164-'2") 8'0 613,55 *355:0 r2