1980, 08-06 Permit P80-8182 Plumbing FixturesAPPLICATION/ PEI1MI
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
4.
JOB ADDRESS
LOT BLOCK 1SUBOISION
OWNER
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
CONTR
01-1
DRESS err
ZI P
North
5. ADF�' / , L / /9 �
CHANGE OF USE FROM ITO
6.
TYPE
7. OF
WORK
PHONE
2..� 2
PH
rNEE ;7
ZIP
Size of Parcel
Actual Set Backs in Feet
1South East
Zone Classification
Type Const.
Valuation
Main Floor
I�CVEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
r❑ BLD. I PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Occupancy
Upper Floors
Area of Decks
West
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement j
Unfin. Basement
No. Baths No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. - USE CODE
VALUATION SOURCE GAS I ELECTRIC WATER SEWER Ownership
OF Public Cl Private ❑
9 UTILITIES
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 regu tjrfQ construction r the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Enum. Dist. I Location (Area)
DATE OF APPLICATION !/ ///frd
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
x ALL t---
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
FEES COLLECTED
Single $
Building
Plumbing LC✓' er)
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
C% 0
%' 180 -6!8'z
U3* *5800
*5800
*58006
*0,00 8
818.12
08-06-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 8 -- 0 6 '- 80818,2
*58.0.0"
Builldin%,/
Technician
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