1981, 05-19 Permit: 81A-4872 Plumbing Fixtures IPLAN NUMBER APPLICATION/PERMIT , PERMIT NUMBER
t £sift - I-572-
b SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS tj� } * * 1. 0 0
+fa LEGAL DESCRIPTION — SEE ATTACHED
1. _ 6•3L . z * 21.00 17)
LOT O K SUBDIVISION PARCEL NUMBER/S
2. * 21. 00
O ER // PHONE
3. &Ilea- Cgiieelehie,) _
ADDRESS ZIP Actual Set Backs in Feet 4 8 7 1
North 'South East (West
CONTRACT,,OR PH NE Size of Parcel Zone Classification 0 5 1 9-8 1
f- • ,/,,,
4. AD S ,4�// IP / / Type Const. Occupancy Sprinklered p 6.4 7 C,
X / 4 e ..y2006-# bf °Z.0 ❑Yes ❑No ❑ Req'd.
DESIGNER 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 1
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
0 NEW ALT. ❑ AD'N. 0 RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK 1:1BLD. E.] PLMB. ❑ MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE Wp1ixK Enum. Dist. I Location (Area) T
8 .--e414. �� e� FEES COLLECTED
VALUATIO SOURCEE GAA S 41t-le.-
WATER SEWER
Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0 - 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 Building
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 wA:X9
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTION ♦ Plumbing#4411V I"
ow
DATE OF APPLICATION -'40.-cri SIGNATURE OF APPLICAfy,• 1,1_��/L irMech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health /— k".„2.7 1
Planning /` ;;r .? a.
jSEPA
� Mobile Home O
Fire Marshall /� / `��� w
r
Co. Engineer
w/ISAe /y�i_y.Q//
Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buil T 'clan 1.., PERMIT IS NONTRANSFERABLE 0 I51k7'll"9"•:'8'1' 418 rZ21,
2'z * 210'0' a F
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
1