1981, 06-29 Permit: 81A-6444 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING GODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
33/ 2 ,U• 'Cw,p►4f
BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
5.
OWNER
P'/iSCO u'z-Dte_5
ADDRESS
CONTR TOR
64,46 Si* e -
PHONE
ZIP
ADDRESS
13.203 f" Fa co
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
PHONE
z*P/
PARCEL NUMBER/S
PHONE
ZIP
TO
gr..1\1EW D ALT. ❑ AD'N. El RPL. ❑ MVE.
❑ BLD. likPLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
❑ OTHER
VALUATION
9.
SOURCE
OF
UTILITIES
/6 .below fS
GAS
ELECTRIC
WATER
SEWER
Actual Set Backs in Feet
North South East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Elves ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area
Area of Decks
No. Baths
Finished Basement
Storage
Unfin. Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
No. of Dwellings
Req'd.
Recd.
Not Req'd.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
1 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 _ �1
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bui ing Tealnician
e:-.1F-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
t o "2,444
03* *45.00
*45,00
*45,006
A *0.00
644.38
06-29-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O'6t'12�'-'81. 64442 *4500a�
DATE ISSUED PERMIT NO. TOTAL