1981, 01-19 Permit: 81A-648 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 4 COPIES
JOB ADDRESS
LOT
BLOCK
3.
NER
%/
SUBDIVISION
it
ADDRESS
C NTRACTO?Th
4. ' /`O w K.�
5. ADDRESS
ADDRESS
:I 45— 7 #7
DESIGNER
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
CHANGE OF USE FROM
6.
7.
TYPE
OF
WORK
PHONE
ZIP
TO
tollEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
DESCRIBE WORK
8.
VALUATION
9.
Sourcce
of
Utilities
GAS
ELECTRIC
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Elves ONO ❑ Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
Storage
Rancher
No. Rooms
Req'd.
SEWER
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,gulating construction or the
performance of construction.
DATE / /! O
er
SIGNATU
DEPT.
SPECIAL APPROVALS
REQ'D_ REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
A44 L X
FOR GAS : /d.4_0 5 tr /Fib—
\ PIPE SIZES: / iPiK
PIPE LENGTHS:
BTU'S: ' ga7e $
ed -3 OD 0
DATE
APPROVED FOR ISSUANCE
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
4905
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
PER,
Other (Specify)
TOTAL
$ /e/
DATE
A PERMIT NUMBER
AjiF'`) ll
-6 ,0/
03* *61,00
*61.00
*61,006
A *0.00
6ia7
0'1.-19-8,1
6479,
— w
a
rn
VVHEN MACHINE VALIDATED IN THIS SPACE,
THIS BE.GOMESA PERMIT.
0 '1 k 19' 7:8
6482 *6L004F