1981, 06-22 Permit: 81A-6158 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
/64/7 /4,3
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER p
3. lD✓•e„wy Ctoev.0 l Lc*to
ADDRESS /
/ 0/04 f
PHONE
9.2 )1-55104
ZIP
PARCEL NUMBER'S
Actual Set Backs in Feet
North (South
East
'West
5.
CONTRACTOR
k,T";
ADDRESA V /Bolt /IOI.a.J
DESIGNER /(
PHONE
yKS 3v7/
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 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.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
DhVEW
CKBLD.
❑..+++ALT. 0 AD N.
XPLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R egid.
ReC'd.
Not Req'd.
DESCRIBE WORiCer
8. � ! /2/M
(.��oJoJ
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECT/RIC
1 el/ i X7Ce 5
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public ❑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 INSPECTIONS
DATE OF APPLICATION
—is-- &/ SIGNATURE OF APPLICANT C= �-;'"1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
7K1s —2
pSIo , c4-5 —/
7e/e/s— 3
.Caws — 3
Sf• /
/;D
nB,o-nfks •
pc—'4 /j4ne
/ -L90
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 78 �loc
$Z"
Mech.
Plan Check
SEPA
Mobile Home
C QS
Other (Specify) ✓ xic
5
$
TOTAL
P IT NUMBER
6/A-6158
03*
*57.00
*57.00
6157
06-22-8:1
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06V2112'I-'8YY1'
DATE ISSUED
•
1,5,I8
6Iz.
PERMIT NO.
*5700a°F
TOTAL"
T
0
U
LLI
J