1981, 06-04 Permit: 81A-5500 Plumbing FixturesPLAN NUMBER - •
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
�. S. 3625 Woodruff
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
W.R.S. & Associates, Inc.
PHONE
928-3380
PARCEL NUMBER/S
S.
326 Pines Rd., Spokane, Wash.
ZIP9206
Actual Set Backslin Feet
North 'South
East 'West
4.
CONTRACTOR
Miller's Plumbing
PHONE
483-2025
Size of Parcel
Zone Classification
ADDRESS
E. 623 Liberty, Spokane, Wash.
ZI P
99207
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
NEW
❑ BLD.
❑ ALT.
X. PLMB.
❑ AD'N.
❑ MECH.
El RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
•
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Plumbing Installation - New - SFR
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
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
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
DATE OF APPLICATION 06-02-81
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
14 Fixtures @ $4.00 ea. + $5.00/Permit Fee = $61.00
1) Kitchen sink, 1) Dishwasher, 3) Basins, 1) Tub,
2) Showers, 3) Toilets, 1) Laundry, 1) Water heater,
1) Floor drain.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
Fee
TOTAL
56.00
5.00
$ 61.00
PERMIT NUMBER
<1,k - "SSUO
03* *61.00
* 61,00
* 61,00
A *0.00 S
549,92
06-04-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,O bj :,. O 4 781
DATE ISSUED
550.02 *6100J
PERMIT NO. TOTAL