1981, 05-21 Permit: 81A-4978 Plumbing FixturesI_ APPLICATION/PERMIT
SPOKANE COUNTYUNTY-- BUILDING CODES DEPARTMENT
/ NORTH all JEFFERSON /SPOKANE, WASHINGTON 99360 / (509)456-36]5
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
i(/ /. Z..,O L .. _o_, kms-. O 1 LEGAL DESCRIPTION —SEE ATTACHED
3,
ADDRESS
CONTRAC
4' gDGRESS
GESIGNEI
5' wb RE55
ZIP l gt[Ual Sef Backs in Faet
SPO Size $OU<M1
PHONE Size of Parcel
f1 31
ZI Ty Pe Const Occup
ao
PHONE Valuation
ZIP E Main Floor I local I
❑Vas ❑No ❑
PERMIT NUM�ER
P 8i� - 47
03+ 3300
a3_�0 m
*33.00
A *003 E
49772
CS -21-81
64?9.
� t
TYPE NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE.
], OF �/ CO3 OTHER
WORK BLD. LMB. ❑ MELH. ❑ M.H. El
RK
No. Baths
No. Stones
No, Roomz
No, 01 Dwellings
CERTIFICATE
EXEMPTION
Re0'4.
RICO-
oI Raclin-
DESCRIBE WORK
8. /y1 �l4N+6! Cui� —6—
Crum. Dist.
Location (Areal
FEES COLLECTED
Single $
VALUATION SOURCE GAS ELECTRIC WATER WER OwnenM1 IF USE CODE
OF PUUIIc ❑Private ❑
9. UTILITIES
1 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
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION "/ SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
.74
Plan Check
Env. —Health/,¢y
/ �" U
Y/
SEPA
Mobile Home
Planning
Fire Marshall
/ — II
/
Other (Spe cilY)
ca En9inem
Utilities
\\
� � rr p•
TOTAL $
Plans E.aminer
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
IN TH IS SPACE,
SEPA Chnckl let
PERMIT IS NONTRANSFERABLE
Q 5;_'211?81'Z
4 9 7.8 zd 3 1 0 Q °a j�
BOImmP Tek
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED f
PERMIT NO. TOTAL