1981, 01-16 Permit: 81A-573 Plumbing FixturesR
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
LEGAL DESCRIPTION — SEE ATTACHED
1. 2 —
LOTj=E3DIVI5IUN—PARCELNUMBER/S
2.
OWNER PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
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Env. Health`
North South
East West
CON ACTOR
PHONE
Size of Parcel
Zone Classification
z - �V-2
4' LADDRESS
ZI
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Baseme
6.
TYPE &11 -EW 11AD'N. 11 RPL. ElMVE.
No. Baths
No. Stories
No. Rooms
No. of Dwel
7, OF ❑ OTHER
❑ BLD. LMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not R;
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8
VALUATION
SOU
GAS
ELECTRIC
WATER SEWER
Ownership
9.
OF
I UTILITIES
Public ❑ Private ❑
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisi
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances g
type of work will be complied with whether specified herein or not. The granting of a permit does 1presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construperformance
of construction,SEE REVERSESIDE FOR REQUIRED INSPECTIONNSPlumbing[BATF
nF APPLICATI(1N / X / SIC;NATl1RF nF APPI ICANT /YAC -✓m iMech.
SPECIAL APPROVALS
NAME DATE
SPECIAL
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CONDITIONS:
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Env. Health`
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Builciv Tech cian` PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
8 ` S"i3
TOTAL $�e I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.0 1, '} 6°- �*89.000-1-
57.13za.-