1981, 03-23 Permit: 81A-2693 Plumbing Fixtures •lol_AN NUMBER APPLICATION/PERMIT PERMIT NUMBER
y'J� SPOKANE COUNTY — BUILDING CODES DEPARTMENT F/4. - h&,9..'";fO/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
ll APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
03 * * 69.00
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED1. .9, 0 0
16
LOT BLOCK SU I SION PARCEL NUMBER/S
2. Q -7 � ,r L� __ * 6 9.0 0
OWNER l/ ( PHONE A 0,0 0 8
3. ADDRESS / h� 4�1 9 P.` � -/ Actual Set Backs in Feet 2 6 9. 2
i f � / ,' !1 . North South East West 0 3 2 3-8 1
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ' ,i A / 2 6479,
AD,pRESS ZIP Type Const. Occupancy Sprin❑Yes ❑No kl❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
M
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE 0, USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE No. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. z PLMB. I=1MECH. IDM.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORKJ� = Enum. Dist. Location (Area)
FEES COLLECTED
8. .-f /`� t: //f✓,.-y- f/ (f,-..4% ,
VALUATION SOURCE GAS EL CTRIt WA ER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private ❑
Single $
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 Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the y4 ,.4
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS / Plumbing 6' /
SII A--D
ATE OF APPLICATION - -j �- i� SIGNATURE OF APPLICANT L 'i - Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE �'�}�fit� Plan Check
Env. Health 91/A4'MI- (J�/ '
e,o- O SEPA a
Planning U
` 14-- - w
Fire Marshall ,/�� pp /� - Mobile Home —J
''y"i1.da�'i 11,I,t u.4-,t -. L•1" LL i
Co. EngineerOther(Specify)
q-r 17– .Li +..¢-i'=
UtilitiesC� 4`/L ✓,y -f^x..^ / -
TOTAL $ 9
Plans Examiner I-Cj,u--,,,aiL{. ,(/l t_-t1
�J I WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist P7/1/711:i,.. 1C�[-,x��/�c--, ..A�•L>46-1 THIS BECOMES A PERMIT.
BWIdin• Tec nici. � �PERM T IS NONTRANSFERABLE 0 I3�I`21�3!t"'8 11 2 6 9 3 °z *6 9,0.0 a
),./ -/'f.�'i. -- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
1