1981, 01-23 Permit: 81A-790 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 3 COPIES
1.
2.
JOB ADDRESS
Ni.*IS EuEtlLemisi
LOT
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
3.
4.
5.
OWNER
_10NH 14OLDEtJ
PHONE
Gt2tp'78/d1
PARCEL NUMBER/S
ADDRESS
r1.4a15 Evekauriv
CONTRACTOR
SAME
ADDRESS
SAME
DESIGNER
ZIP
1tzzco
Actual Set Backs in Feet
North 'South [East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ADDRESS
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
tif NEW
0 BLD.
❑ ALT. 0 AD'N.
VPLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ 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. 1 T QJE55
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 INSPECTIO
DATE OF APPLICATION ,J 3 2
(
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building
f7ti4 f- / °2-
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
bllvl!
1 'T 1A b
1 S F;DU.ZQ.
1 e.i"re.RElhi SiN�
L1.)145H1NL, (YI An41NE -DQAIr�I
w/CG
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 2a.60
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 2A.1,40
r - N'J'yi B E R I
p siA --Kt,
03*
* 29.00
* 2900 17)
7892
01-23-81
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01'-23'-8'f
DATF ISSIIFD
79.0'
PPRMAIT NCI_
*2'9.00 —
TOTAL