1981, 04-03 Permit: 81A-3083 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
4.
JOB ADDRESS
7 1! '(VL'
LEGAL DESCRIPTION — SEE ATTACHED
LO T
BLOCK
SUBDIVISION
PAR'=EL NUMBER/5
OWNER
FLi) 4_'f iV,(..4" Fe L6 Ea.
ADDRESS
CONTRACTOR
?LA t 1t31t;e 1
PHONE
ZIP
Actual Set Backs in Feet
North (South
East
(West
PHONE
9f 214'Z
Size of Parcel
Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
U NEW
❑ BLD.
❑.,/ALT. ❑ AD'N.
2 PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. ? FiY>,1%., ?' 7 R 51;%,K \'t' L.
Enum. Dist. 1 Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
WATER
SEWE R
Ownership
Public ❑ Private 0
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 -3 T ( SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building T hnician
4
�r
SPECIAL CONDITIONS:
i Ki tl N 5tp
i TA1 W U tnrt
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 171'n.'7
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1
PERMIT NUMBER
66* *1300
* 1300
* 13.006
A *000 S
308.2
04-03-81
g 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0403-81 30&32 *13.0.0RR' —
DATE ISSUED PERMIT NO. TOTAL
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