1981, 07-01 Permit: 81A-6597 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 4 COPIES
JOB ADD SS
1. /04LO/
2.
LOT
BLOCK
SUB (VISION
OWNER /PHONE
3. �i/ �{jraG/Jfar
D/ES
ADS 7 6/(O
zIfr ffS
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs In Feet
North 'South (East 'West
4.
CO NTR R
ADDRES 021
P ' 761P
zIP_ /02/6
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
6' ADDRESS
PHONE
Valuation I Building Area i Sq. Ft.
ZIP
DWL Area
Basement Area 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
SPIIt Entry
Split Level
Rancher
TYPE
7, OF
WORK
KKE-Cv 0 ALT. 0 AD N. 0 RPL. ❑ MVE.
❑ BLD. ❑ PLMB. I] MECH: ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
WI WORK
8.
VALUATION
/o
Source
of
Utilities
AS
ELECTRIC
WATER
SEWER
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 regulatingcons tigu r the
performance of construction. b IRAN X> PLUMSIN bI
GATE 6 —� 0 —C / SIGNATURE / `L
•
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:-
/
40
DAT
APPROVE) OR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 174C1012
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
//6"--`9°
PERMIT NUMBER
8/4 &6Q7
DATE
03* *4500
*4500
*45006
A *Q00
659,62
07-01-81
2 6479,
WHENtMACHINE VALIDATED IN THIS SPACE,
THISBjCOMESIA PERMIT.
•
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