1981, 10-14 Permit: 81B-0674 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
1. E. tO(3S 44C:8-MANLOT BLOCK SUBDIVISION
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER
3 etw12.S.l •bAlilS
ADDRESS
1111,A a IQ
PHONE
ZIP
6361 al"
Actual Set Backs in Feet
North (South [East 'West
CONTRACTOR
4. AC.P163C �L.L v't pJCi
ADDRESS
PHONE
97.40.01gS
Size of Parcel 1 Zone Classification
ZIP
cc e
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation 1 Building 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
NJ NEW 0,.,.,//ALT. 0 AD'N. 0 RPL. 0 MVE.
LY
❑ BLD. PLMB. 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. 13 FIX-ru2cS
Enum. Dist.
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 INSPECT((
DATE OF APPLICATION /d- /Sl - CJ t
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Check(
Bu (ding Technician
4
•
SPECIAL CONDITIONS: tt'
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- BAP_ Sir--
PERMITIS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify).
TOTAL $57.0a
PERMIT NUMBER_
g l3 ' c7cj'14,-
03* *57.00
*57.00 63
*57.00'6
A *0.00
67,38
10-14-81
g 6479,
it
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'�11'o1- i 4 :'i8i11
6�7.4z
DATE ISSUED PERMIT NO.
TOTAL
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0
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