1981, 06-24 Permit: 81A-6272 Plumbing FixturesJ
PLAN 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 4 COPIES
1.
2.
3.
JOB ADORE'S 7
2
2
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PHONE
ZIP
lc9c2/4
PARCEL NUMBER'S
Required Set Backs in Feet
North 'South East 'West
4.
CO NT'K.�i✓'CSL, Gi/__"_. ('
PHONE -
q&,,c —74 fe
Size of Parcel Zone Classification
ADDRESS d r"2 /
ZIP 7�/ ,
_
Type Const.
Occupancy
Sprinklered
❑Ves ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW ALT. 0 AD N. ❑ RPL. 0 MVE.
❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC:Q' WORK
8.
VALUATION
9.
Saco
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . 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. STR L ! n Br
��11 _ i L E)l�Jl u{�
DATE —atm —EP/ SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Ent Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
L
, 4cria
DATE OF CIA
A P ROVED IS
FEES COLLECTED
Single $
Building
Plumbing a� 00
.2
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $a/•.o0
P
PERMIT NUMBER
S1%—(02.72—
DATE
03* *21.00•
* 21.0.0 N
* 21.000
A *000 8
627.1
06-24-8}1
2 6479.
WHN MACHINE VALIDATED IN THIS SPACE,
THI� �17 1= fA' MIT. ;I 1�
1 "!4 �r% 6 2 7:'2" *21'0:0 2A .
— t