1981, 10-12 Permit: 81B-0561 Plumbing FixturesPa -AN 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
1.
JOB ADDRESS
LOT I BLOCK sUBDIVISION
OWN5R
3. :>R®f 5 e -BK
ADDRESS
2.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
4.
5.
CON T7N� i rpt5Qrag
ADDV
7 g _
DESIGNER
Zb'--%DItZ
Z 2_c76
PHONE
ADDRESS
ZIP
Actual Set Backs In Feet
North (South East 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves 0No 0 Req'd.
Valuation Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
0 ALT. XAD N.
APLMB. 0 MECH.
❑ RPL.
0 M.H.
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK f�
B. -CAt elm
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
AS
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 INSPECTIONS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Ut11t les
Plans Examiner
SEPA Checklist
Building echn clan
SPECIAL CONDITIONS:
/) -
-
, /5114-k
f
La -VI
1 — 0, J waJoi.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing a2g' 0o
Mech.
Plan Check
SEPA
Mobile Home
Ot er (Specify) n<' 011
2
TOTAL $ 2--5`06:1
PERMIT NUMBER
8 - ocisc,
03* *2500
*2500
*25006
A *000
5602
10-12-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l;fl! .th112sl8"1.1
DATE ISSUED PERMIT NO.
5 61= * 2 5,0'0,2
TOTAL