1981, 02-23 Permit: 81A-1766 Plumbing FixturesLLAN 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 ADD ESS
1. Q •0'
LOT LOC SUBD • ISION
OW ER
ADDRESS
2.
3
6u e rl S o >�
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
Actual Set Backs in Feet
North 'South East 'West
CONTRACTOR jj��. PIJVIA 4. OO-- t rl
ADDRESS
i 1 0 7 f. IL/0
DESIGNER
5' ADDRESS
ZIP
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
PHONE
Valuation 1Building Area in Sq. Ft.
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
C�<NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 MECH. 0 M.H. 0 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.
VALUATION
9.
SOURCE
OF
UTILITIES
q �t v' Tv e s
GAS ELECTRIC
Enum. Dist. I Location (Area)
WATER
SEWER
Ownership
Public ❑ Private 0
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIPat-
SPECIAL
NS �J
DATE OF APPLICATION .02- e2 3 — �l SIGNATURE OF APPLICANT
APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ilding
clan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Ern) rt — o
ther (Specify) •
TOTAL $ ` L�. V Q
PERMIT N'JMBEP
'1J IG(e
03* *41.00
*41.00 V,
*41.006
A *000
17652
02-24-81
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
024-$l 176.62 *4100.2g. _
DATE ISSUED PERMIT NO. TOTAL