1981, 02-19 Permit: 81A-1639 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
JOB ADDRESS nO�C1(/., S
LOT BLOCK SUBDIVISION
VISION Ay\
2.
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
ADDRESS
C N RACT R efrAlititS
4. AaA ac�
DES' NER
5.
PHONE
924'- 9/o 7
ZIP
99e37
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South [East 'West
PHONE
3a4,0 SfoOO
Size of Parcel Zone Classification
Z /q 3/
Type Const.
Occupancy Sprinklered
Dyes DNo 0 Req'd.
PHONE
Valuation Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
0 BLO.
D ALT. YJ AD N. D RPL. 0 MVE.
APLMB. 0 MECH. D M.H. D POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
DESCRIBE WORK
VALUATION
SOURCE
OF
UTILITIES
GAS o
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
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 I����yyy re�} ting construction or the
performance of construction. E RE ERSE SIDE FOR REQUIRED INSPECT' �'
DATE OF APPLICATION
SIGNATURE OF APPLICANT
ALL-
•
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshal
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
-
/ 1-41Athee
/ Srwk
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building /^
Plumbing I h d o
Mech.
Plan Check
SEPA
Mobile HomeO- nn
Other (Specify) V
•
TOTAL $7b oo
PERM .0•2UMCS_R
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•'11
i65.9 a 4210.0 a' -
DATE ISSUED PERMIT NO. TOTAL '
›-
Li -
WHEN
LL