1981, 01-19 Permit: 81A-633 Plumbing FixturesL_AN NUMBER
1.
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 ADDIIESS
2.
3
LO V
BLOCK SUBVISION��`
DI
1
4.
CONTRA TOR/
PHONE
ZIP
PHONE
�,H/j
O N E
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
ADD
/1.34e,23 --
DESIGNER
5. ADDRESS
Type Const.
Occupancy
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
TO
i1NEW D ALT. ❑ AD'N. ❑ RPL.
❑ BLD. lat-PLMB. ❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Sprinklered
!lives ENo ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Area of Decks
Finished
asement
No. Rooms No.
Req'd. Rec'd.
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Storage
Unfin. Basement
DESCRIBE WORK
8.
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC 1 WATER
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 INSPECTIONS
DATE OF APPLICATION
///3/57 ,NATURE OF APP LICANj��
SPECIAL APPROVALS
NAME DATE
Env. Health
nq
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
nician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
of Dwellings
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing /r�J�
j9%
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
491% - (.
03*
*7300
*73.00 tz
*73.00
*0.00 0
632
01 —1 9-81
z 61179,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0:1.+1+78:11 6332 *730020
DATE ISSUED
PERMIT NO TOTAL