1981, 01-27 Permit: 81A-0963 Plumbing Fixtures PLAN NUMBER PERMIT NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT , 6 A -0, 0
VNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 0 '� * 3.1.� .� ��,-tAi� iAj LEGAL DESCRIPTION — SEE ATTACHED 1 3 0
1. ), I 0 u)
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. `2 rslt-'`- A 0 2 i--1'1 ci, 9 6 2<_
OWNERp T'�, , HONE
3. —__JodA-rte �`� m� �' , `✓Zv -QO .! 1 -2%-8 1
ADDRESS ,•� ZIP_ Actual Set Backs in Feet =5.' 6 4 7 9
.-' Ae 19-1 2 i, 19 1, �`I���" r'' 9, .'-4� North (South East 'West
CONTTR CT R PHONE Size of Parcel Zone Classification
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF ❑ OTHER
WORK
0 BLD. PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE
W RK Enum.Dist. I Location (Area)
$ ri. ` 01 : r-- rix-dil
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC
WATER SEWER Ownership USE CODE
OF
9. UTI LLITI ES, Public ❑Private 0 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 Building
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 1�.'
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing I
DATE OF APPLICATION__II`- SIGNATURE OF APPLICAN " ®'� "�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: //
NAME DATE C I Plan Check
Env. Health I'JK7
SEPA
Planning O
CD
Fire Marshall Mobile Home "-1
J
ii:
Co. Engineer Other (Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
—Buit�gg T n'cian PERMIT IS NONTRANSFERABL -....8 '; c3' O _.l
7 ----- �-"�--s' 01� 1' 9 6�:3 Z *1' 0 0 a (-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL