1980, 09-18 Permit P80-449 Plumbing FixturesJOB ADDRESSJQS 08
LOT
BLOCK
SUBDIVISION
OWE —
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AD E 15l i./vaci`'�
CONTR�ACjI tll/ T[J tit/[ 1 Llrultd
PLAN 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
1.
2.
3.
4' ADDPeESS4 ^
f/1p/ ^�`7/r<
DESIGNER
5' ADDRESS
PHONE
ZIP
PHONE
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South [East (West
Size of Parcel
Type Const.
Valuation
ZIP
DWL Area
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
IVEW r❑����ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD.l�LMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
Split Entry
No. Baths
Occupancy
Basement Area
Zone Classification
Sprinklered
DYes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
Storage
Rancher
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WOR j j
8. i \ 1w'
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 staor cal law regulat'' • construction or the
performance of construction.
DATE / O SIGNATURE
DEPT_
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL
APPRf)VF[) FOR ISSUANCE
FEES COLLECTED
Single S
Building
13
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $3E+
PERMIT NUMBER
DATE
03* *35.50
*3550 rn
*35.506
A *0.00
44,42
09-18-80
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES j PERMIT.
D9--:18 8;G` 44,90 *35.5T)
In QDCf Tf1D