1981, 01-06 Permit: 81A-0090 Plumbing Fixtures 'PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER •
i SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 •
_ P..)
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESSy 4 � ���j0
(j¢ '� fWJ7�/I/�L LEGAL DESCRIPTION - SEE ATTACHED ~ * * j 01 273
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * r= 'U (, u)
2. * 5300`:
OWNER trz PH NE
ADDRESS ,r ,�L ZIP Actual Set Backs in Feet
/5 30/ /q� North 'South (
�,
C N R CT R PHONE Size of Parcel Zone Classification 0 1 _0 6_8 1
3a40-5Z0 DO
4' A DR S /3 a ZI�9a D r Type Const. Occupancy Sprinklered , 6((
/��,//j/�, ❑Yes ❑No ❑ Req'd.
D SE IGNER 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. 0 MVE.
7 WORK 0 BLD. LMB. 0 MECH. 0 M.H. ❑ POOL OTHER CERTIFICATE
Req'd. Recd. Not Req'd.
////// of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8. /a ie....-- I FEES COLLECTED
VALUATION
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES 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 reg lating construction or the /l,- .t1G y�
performance of construction.S` E REVE'SE SIDE FOR REQUIRED INSPEC at N' / Plumbing �0
/ 111111_401
,! __,—�
DATE OF APPLICATION SIGNATURE OF APPLICANT +`�� Mech.
SPECIAL APPROVALS SP-CIAL CONDITIONS:
NAME DATE Plan Check
Env. Health q 3_ S{,
4-3t
j C SEPA c,
Planning3 ,-_,
Fire Marshall ~ / 714,(g, Mobile Home
4v is
Co. Engineer S vw' *1
Other (Specify)
Utilities r /e°. S,n ft' y
,LL // TOTAL $ �J3C�
Plans Examiner ter: to,. �T
`
f D I WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist - THIS BECOMES A PERMIT.
��Buil Techgyc' n •f PERMIT IS NONTRANSFERABLE ' L • , nn -
"- P. 1 L;0 • � PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED lir w Y PERMIT NOy,Q z 1t
5 3.'Q a '