1981, 03-27 Permit: 81A-2835 PlumbingPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
1.
2.
3.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE
JOB ADDRESS
E. 11114 Alki
LOT
BLOCK
OWNER
Mike Thome
PHONE
90056
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
ADDRESS
8921 Walton, Spokane, Wash.
2199206
Actual Set Backs in Feet
North 'South East 'West
4.
CONTRACTOR
Miller's Plumbing
PHONE
483 -2025
Size of Parcel
Zone Classification
ADDRESS
E S623 Liberty, Spokane, Wash.
ZIP
99207
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation I Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
NEW
❑ BLD.
E ALT.
Ld PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. Plumbing installation - New - SFR
Enum. Dist.
Location (Area)
Req'd.
Rec'd.
Not Req'd.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 03 -24 -81
SIGNATURE OF APPLICANT Qd-'
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ding 'chnicia 'ail
13 Fixtures @ $4.00 ea. + $5.00 Permit Fee = $57.00
1) Kitchen sink, 1) Dishwasher, 3) Basins, 1) Tub,
1) Shower, 3) Toilets, 1) Laundry, 1) Laundry tray,
1) Water heater.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
Fee
TOTAL
52.00
5.00
$ 57.00
PERMIT NUMREr- f
e /A Z53
0'3#42+7?- `81'''
03* *57,00
*57.00
*57.006
A *0.00
28'342
03- 27-81
z 6.4 7 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
285 g. *57.1302-
DATE ISSUED PERMIT NO.