1981, 06-04 Permit: P81A-5515 Plumbing FixturesPLAN 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 3 COPIES
JOB ADDRESS
1O)
•
BL
•
CK
3.
OW NI _lf2
E
VV
A I-
SUBDIVISION
4' ADDRESS
AD1014t ESS
19 1,6'71
CO NTRACT
•
DESIGNER
ADDRESS
CHANGE OF USE FROM
TYPE
7. OF
WORK
DES
II
NEW
❑ BLD.
PHONE
ZIP
PHONE
ZIP
PHON E
ZIP
TO
❑ PLT. ❑ AD'N. ❑ RPL. ❑ MVE.
MB. ❑ MECH. ❑ M.H. ❑ POOL
19L1-11\4 911\1 —1 rIx�I] t' (
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North South East 'West
Size of Parcel
Zone Classification
Type Const. Occupancy Sprinklered
Elves ❑No ❑ Req'd.
Building Area in Sq. Ft.
Valuation
Main Floor r Upper Floors Garage Area I Storage
Area of Decks Finished Basement Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
WATER
Enum. Dist. I Location (Area)
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 INSPECTIONSO,- �'�- �V�- 0
DATE OF APPLICATION " ^ � SP/ SIGNATURE OF APPLICANT L^"� 7 /:yr-
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildm
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
c2
PERMIT Nt"wBER
e cA — -q15
03* *9.00
*9.00
*9.00
A *0.00
551,42
06 -04 -81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
016; &: 4; 8'1
DATE ISSUED
5515'g *900 -
PERMIT NO. TOTAL