1981, 08-25 Permit: 81A-8546 Plumbing FixturesDESCRIBE WORK
V
VA UATION SO CE
OF14
9. UTILITIES
PLAN NUMBER
(✓
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDINOCODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. .f , !PIA ;:'; ��• S 39 2-3 IA) t ;)fia/P (LD
LOT BLOCK SUB( VISIO /�
2. ( , r��,a �-�2.c c1'' / -D %� PHONE
S3s-/77 Jo
OWNER
3. I Iv it` srfo
ADDRESS
'3ga ( din? (4V
CONTRACTOR
NIF
LEGAL DESCRIPTION - SEE ATTACHED
ZI P
Q947-10),
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East 'West
ah VA- ai urt-)afN
4.
ADDRESS
PHONE
6 172--3a,3
ZI P
38/5/
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑No D 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 ❑.( ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
D BLD. LJ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
I3 F�x�Cwrz.c,
GAS
ELECTRIC
Enum. Dist.
ILocation (Area)
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 y�A
DATE OF APPLICATION 1' a s / ft SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Build i g Technician
1- 5..1.4we(L
-t &.�1
r- kcr 5,r4e
i' pis 0ANJA-Si1tW
" iluv T
v— L 1j"?tyP PERMIT IS NONTRANSFERABLE
I- fi
PERINIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 5 'UO
PERMIT NUMBER
'a U S#4'
03* *57.00
*57.00 b5
*57.006
A *000
854.5
08-25-81
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
C1-25:-81' 8 5 4 6 5 * 5 7.0 0 t10.
DATE ISSUED PERMIT NO. TOTAL