1981, 04-01 Permit: 81A-2938 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
LOT
BLOCK
/Sog /�/•t//.(gem
SUBTTV ISION
LEGAL DESCRIPTION - SEE ATTACHED
2.
OWNER I r
3. IV ra.-- 4IPS 0
ADDRESS V19/(2,412.4.4a—
CON
TRACT9y��
Czo tD 5rc.9 c %t rr b4dre..Qc_,
4.
5.
PARCEL NUMBER/S
PHONE
ZIP
99.24 4.
Actual Set Backs In Feet
North 'South
East
West
PHONE
Size of Parcel 1 Zone Classification
ADDRESS ti - f•
DESIGNER �`V y��`'•'~—''_�I'/
Type Const.
Occupancy
S•prinklered
❑Yes DNo 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
Unfln. Basement
TYPE
7. OF
WORK
.CNEW 0 ALT.
❑ BLD. aPLMB.
0 AD N. 0 RPL. 0 MVE.
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. /0 F/ s7/• -au
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 regul construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION / SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
a w�
/ —03
/&,/3/Lai
S/Ott
male/GL-
4) N.
/ WC}
4,4 -line t� lr'i?* e/ze
/f-i-8i-oK iL-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 45,09
09
PERMIT NUMBcR
03* *450,0
*4500
*45006
A *000
29374
04-01-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
;0'411,. PE.7.E4j
2;9.182 *'415,00ak
DATE ISSUED) ' PERMIT NO. TOTAL