1981, 06-29 Permit: 81A-6446 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
3 3o y a(J. 6ela,,WIW
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
4.
5.
OWNER
---e0c-o s<s
PHONE
PARCEL NUMBER/S
ADDRESS
CONTRAC�'OR
ZIP
DL -O Atte i. _Toe .
PHONE
Actual Set Backs in Feet
North (South 1East (West
Size of Parcel 1 Zone Classification
ADD R SS
G)3 r
DES' NER
ZIP
Type Const.
Occupancy
Sprinktered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin, Basement
TYPE
7. OF
WORK
�LNEW El ALT. ❑ AD'N. 0 RPL. ❑ MVE.
0 BLD. OLPLMB. 0 MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 1C) t=IKTc-tET,
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that 1 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 reguJa ii construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
?c
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
awe
as 840.04
J Tcacs
scot, sw--
O
iv/4
a1 Dad
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing g
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
S T'
PERMIT NUMBER
;3* *4500
*4500 to -
*45,006
A *000
644,52
06-29-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 4 4" 6 Z
DATE ISSUED PERMIT NO.
*45.00r? 172 —
TOTAL