1981, 03-09 Permit: 81A-2164 Plumbing Fixtures PLAN N:_,MBE.< APPLICATION/PERMIT � PER-MIT NUMBER
— r�" 1 h ---2. 1 c‘{-
CJ SPOKANE COUNTYBUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS C r5 * * 2 0 0
1. !'
-T- �,- �-7 A C t LEGAL DESCRIPTION - SEE ATTACHED
8 A. ' * 2500
LOT L CK SUDIVISION PARCEL NUMBER/S
2.
* 25.006
OWNER PHONE A * 0 0 0 S
3. �� `/ L. A '-E
ADDRES5,, ZIP Actual Set Backs in Feet 2 1 6 3 z
-__SA Po t; North (SouthEast 0 3_0 n_8'West O
CONTRACTOR PHONE Size of Parcel Zone Classification 7
4. 1
4 ,t 7) 2L U wt P3 iAlC 3,:17-537. 6 -7 9.
AD -' O . I,, C, x / 76i'/ - cpOk,1�,__ Z1p Type Const. Occupancy Eyes ❑No Sprinklered❑ Req'd.
DESIGNER
R PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ AD'N. ❑ RPL. El MVE.
7. OF �+�r ❑ OTHER
WORK
El BLD. 0 PLMB. ❑ MECH. CI M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd. "
of EXEMPTION
DESCRIBE WORK j [ Enum.Dist. I Location (Area) FEES COLLECTED
k�\8. -P�ui,.. i 1"feC!S I
VALUATION SOURCE GAS ELECTRIC WATER SEWERUSE CODE
Ownership
OF
9. UTILITIES Public ❑Private ❑
Single $
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 07,i5-, C., 0
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 S 9 / Td� SIGNATURE OF APPLICANT �. �� 4 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: _ t7
NAME DATE ? (r 00, -'1\4,11/ k H.A:3 ra._e 6rL4 b, l Plan Check
Env. Health I (,� 5/1FJzYL
Planning I /�- S+ SEPA c
!� T2) 64-,,v eivI rz y - tip.-si _ ,
Fire Marshall J, /2 JIV /� C/ — ^.IC Mobile Home
w/_ 06//1/% R & t1NN C/- t
Co. Engineer I *s� T� Other(Specify)
Utilities
TOTAL $,. e), OC)Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. d
216.42 *2 �9 �a(-.
(ding Te ci n r PERMIT IS NONTRANSFERABLE Q` 1 'a� h'�'1'' -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE;ISSUED PERMIT NO. TOTAL