1981, 11-05 Permit: 81B-1541 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
LO D RESS
OT BLD332- VISIGItl
2.
tEGAZ DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
VER h
Sr` I
3. (f14 6°j(&4)
AD t±E5s5T1 3 / •�n /
ADDRESS / 3 a!
PHONE
ZIP
Actual Set Backs In Feet
North 'South
East
'West
PHONE
oto S(o00
Size of Parcel
Zone Classification
ZIP
99a0/
Type Const.
Occupancy
Sprinklered
❑Yes 0No -0 Req'd.
5.
DESIGNER
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
Unf in. Basement
7.
TYPE
OF
WORK
RI/NEW
0 BLD.
0 ALT.AL0 AD N.
I�PLMB. 0 MECH.
❑ RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
B. 3
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public OPrivate 0
USE CODE
1 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. SE REVE SE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
2/
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Tech n i clan
SIGNATURE OF APPLICANT Al SeLlaart—i
SPE IAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
S'ngle $
Building
41.1
Plumbing
Mech.
Plan Check
SEPA
2 --
Mobile
Mo ile Home
S". Sr
Other (Specify)
TOTAL $
PERMIT NUMBER
ei 6- 154l
03* *17.00
* 17.00
* 17,006
A *0.00 8
15402
11-05-81
6479. -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'''1i. li'i 1f I
hi07,015:i
DATE ISSUED
1:5:411'1' *1'7,00,a�
PERMIT NO. TOTAL