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1981, 09-14 Permit: P81A-9270 Plumbing Fixtures(PLAN NUMBER 1 r 2. APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 JOB ADDRESS LOT APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES L. 1),.' iC( '.z-tyl f2 BLOCK SUBDIVISION LEGAL DESCRIPTION — SEE ATTACHED OWNER 3 C=1rAc n ADDRESS E✓.12.cAiGc CONTRACTOR 4. AVINL ADDRESS SA -VY. DESIGNER 5. 6. ADDRESS Lx.), 1Mitcr s. JC.YVI�I'� PHONE —44.6 ZIP PARCEL NUMBER/S PHONE Actual Set Backs in Feet North 'South Size of Parcel East 'West Zone Classification ZI P Type Const. Occupancy PHONE Valuation Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. CHANGE OF USE FROM ZIP Main Floor Upper Floors Garage Area Storage TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK O NEW ❑ BLD. ❑ ALT. PLMB. DESCRIBE WORK 8. i &-cLkQErs VALUATION 9. SOURCE OF UTILITIES, ❑ AD'N. ❑ MECH. ❑ 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. Enum. Dist. I Location (Area) 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 WDATE OF APPLICATIO SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building Technician SIGNATURE OF APPLICANT SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing ?-Az —.Cx') Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL PERMIT NUMBER tv41/4 'Xi 03* *2500 *2500 *25.006 A *000 9269-6 09-14-81 2 d79, 1 2 c c c — LJ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 09_►141`_81 DA F I' RI IF fl 927, Oz DCDR/IIT rIII *25,00 as