1981, 05-04 Permit: 81A-4252 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
2.
JOB ADDRESS / ° w z 0
LOT CL7 �1/
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
✓
%T 57 srrSd
PHONE
PARCEL NUMBER/S
ADDRESS
ZIP
Actual Set Backs In Feet
North (South East 'West
4.
GONTRACjpR
m •-0 St-4c-kre.44.0te-4C7
PHONE
qk/--sya_3
Size of Parcel 1 Zone Classification
ADDRESS/3p.d �/
I r./ r �V/OIi"o__
ZI4!-2,C
Type Const.
Occupancy
Sprinklered
❑Yes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation I Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Untin. Basement
S -NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. J�PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
F fC7UGrr/
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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. SEEGREVERSE SIDE FOR REQUIRED INSPECTIONS ci
DATE OF APPLICATION "\�I` 4 CC \ SIGNATURE OF APPLICANT'
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Ing T hnici n
i r
SPECIAL CONDITIONS: -
gat,
p-
emeLseivt.
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PEReIT NUt3BER
i(4- —42
03* *4500
*4500
*45006
A *000 8
425,12
05-04-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
" !1
0!5; 0I—'8li
425.2't *:45.00a�
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
>-
0-
0
0
UJ
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U-