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1981, 01-19 Permit: 81A-0604 Plumbing Fixtures
PLAN NUMBER APPLICATION/PERMIT APERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT _ o`� e/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 1—/Z--S1 APPLICANT: COMPLETE NUMBERED SPACES — PRESS'-'ARD;TO MAKE 4 COPIES 1 JOB ADD ` ,ESS LEGAL DESCRIPTION — SEE ATTACHED LOT BLOCK SUBDIVISION PARCEL NUMBER/S 2. CHi aQ E !/+ /Al ,ti J S . OWNER PHONE 3. Di/,A,,� Sr.1Li.p 9 —Z37>y 0 /li �, ew, 5J/t ADDRESS 8 ZIP Required Set Backs in Feet r ` r E. 4 7/6- r=t-'1 North 'South East (West `,) l R,Vif re-'14V CONTRACTOR PHONE Size of Parcel Zone Classification % h- 4. Gt-lai 4.F.>.e /74,0 ,-4/14-c. , 92.1i' Dat 3� y '6 �//ADDRESS i� ZIPTypeType Const. Occupancy Sprinklered -c7� * A ^ 14/i.. 5r-c''7 )- () C1,/ !1o, 7-F0.2.7 ❑Yes ❑No ❑ Req'd. if) C.- "-)Z is G 1. c ?, DESIGNER PHONE Valuation Building Area in Sq. Ft. JJ LLL, 1 f., CI 5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage *2 t c 0 A CHANGE OF USE FROM TO Split Entry Split Level Rancher * 0,, c 6. 603,= TYPE NEW ❑ ALT. Cl AD'N. CI RPL. ❑ MVE. No. Baths No. Floors No. Rooms Rec. Room 0 1 — 7. OF CI OTHER - 4_ WORK El BLD. PLMB. CI MECH: CI M.H. CI POOL CERTIFICATE Req'd. Rec'd. Not Req'd. ,�, 6 of EXEMPTION 479. DESCRIBE WORK 8. 4, FEES COLLECTED I/ ,-41.79,t-1%-%11,--/-,r. VALUATION Source f GAS ELECTRIC WATER SEWER of 9. Utilities 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 performance of construction. •/, Plumbing DATE / "AL- q I SIGNATURE .49••• .---4-0-e-- 1,7.5• '12a(-••)-11k-.t s / Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. ��' /// Plan Check Env.HealteE A cO U#Q r SEPA Planning _ - •-)._ MobileHome v) Fire Marshall Co. Engineer Other(Specify) Utilities TOTAL $T +-© Zone Clearance ,--�--„ ---1- -, WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist ) THIS(.$ CO �A ERMIT. DATE/'-�n-h/OFFJCA ._-- • U�1t 1 6442. *2`L00a - APP /ROVE6 DR ISSUANCE A .