1980, 09-26 Permit P80B-960 Plumbing FixturesAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
BLOCK
to a
SUBDIVISION
e_ r,
3.
OWNER
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
CONT R/T�OJR +' 1 -' L z n'
4' ADDRESS
f 4 II) / 2 (, Irr_ c' f'G 4- 17 ,
5.
6.
ADDpS
p,.o, ,L.
/9 X l � l%
CHANGE OF USE FROM
TO
ZIP
PH7¢E
PH fl
..—e5?
ZIP
Actual Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
Main Floor
Area of Decks
Upper Floors 1 Garage Area
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
EW ❑ ALT. ❑ AD'N. ❑ RPL- ❑ MVE.
❑ BLD. LMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
/ GAS ELECTRIC
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist, I Location (Area)
Req'd.
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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 gting construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION / ,": 3 NO SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing T ��
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3v' cczi)
PERMIT NUMBER
D -9.66
03* *38,00
*38,00 N
*38006
A *0.00
95.92
09-26-80
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
L
L
Building Tec nician�
PERMIT IS NONTRANSFERABLE 9 6 z
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
* 3 8.0 0 at�-