HomeMy WebLinkAbout1981, 04-07 Permit: 81A-3168 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,INASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT BLOCK SUBDIVISION
NNE
3. %'
\ /! /
; ��'�l
/DDRESS
CONTRACTOR
PH O N E O.' ✓'
47;2-
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S U il_/_ /f
r , ,A -AC /I
MAT 9J /Mfii1^.
1�5 1
:4J -
i
AD RESS
. .
DESIGNER
5' ADDRESS
6.
CHANGE OF USE FROM
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
0 ALT.
PLMB.
ZIP
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
Actual Set Backs in Feet
North !South East (West
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Un in. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
D SCRIBE WORK
– /�
8. l sI'/ / /
9.
VALUATION
SOURCE
OF
UTILITIES
GAS
WATI`_ R
SEWER
Enum. Dist.
Location (Area)
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 onstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION/7L— 7—( SIGNATURE OF APPLICANT )`
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu idin
, ,?2 '/f111
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
'‘161
TOTAL $ ✓ 6�
PERMIT NUMBER
Lik
03* * 1 7.00
* 17,00
* 17.006
A *0.00
31672.
04-07-81
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ole; -o-7 81 3168z *17.00 2 -
DATE ISSUED
PERMIT NO.
TOTAL