1981, 04-22 Permit: 81A-3792 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
1.
2.
3
JOB ADDRESS
S. 3902 Woodruff
LOT
BLOCK
SUBDIVISION
OWNER
W.R.S. & Associates, Inc.
PHONE
928-3380
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
ADDRESS
S. 326 Pines Rd., Spokane, Wash.
ZIP
99206
CONTRACTOR
a Miller's Plumbing
ADDRESS
E. 623 Liberty, Spokane, Wash.
PHONE
483-2025
Actual Set Backs in Feet
North ]South
Size of Parcel
East (West
Zone Classification
ZIP
99207
Type Const.
Occupancy
DESIGNER
5.
ADDRESS
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
NEW ❑yy ALT. ❑ AWN. ❑ RPL. ❑ MVE.
❑ BLD. l41 PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
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 04-22-81
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
15 Fixtures @ $4.00 ea. + $5.00 Permit Fee = $65.00
1) Kitchen sink, 1) Dishwasher, 3) Basins, 1) Tub,
2) Showers, 3) Toilets, 1) Laundry, 1) Water heater,
1) Floor drain, 1) Area drain.
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
60.00
Other (Specify) 5.00
Fee
TOTAL $ 65.00
PERMIT NUMBER
81
03* *65,00
*6500 scri
*65006
A *0.00 8
379.18
0422-8.1
z 64 7 9,
_ W
—
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin Technician
94) V ?--
PERMIT IS NONTRANSFERABLE
4;x-'2 8
2-1'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
3b7 9. 22. *65.002P
PERMIT NO. TOTAL