1980, 07-21 Permit P80-7410 Plumbing FixturesPI,AN 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
2.
3.
JOB ADDRESS /.D " �_ ,r,P L'e
LOT
BLOCK
ADDRESS
CONTRACTOR
P/�/frl //-
4. ADDRE„S2 , / G� r7w'/�y/Z/`.0�j
SUBDIVISION
5.
DESIGNER
Ally » 7e p if4/4
PHON
-5 his
ZIP
PHONE
ZIP
r4,Zo 2
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East 'West
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
Lives El No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
EW
BLD.
TO
❑,/ALT. ❑ AD'N.
IAPLMB. ❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Split Entry
No. Baths
Split Level
No. Floors
No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
Source
of
Utilities
GAS
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. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating constuction or the
performance of construction.
DATE
SIGNATURE
FEES COLLECTED
Single $
Building
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE? '/—�6IOFFICIAL ,�.ia,P
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
30 °
C/
Other (Specify)
TOTAL $ cam' Da
PERMIT NUMBER
DATE 7'2/—��
03* *33,00
*33.00 N
*33,008
E *000 B
740,9�
07-21-80
6,479.
I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
2 1. ;1
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