1981, 05-04 Permit: 81A-4272 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
JOB ADDRESS
LOT
BLOC SUBD/ N'AO
OWNER ,,f���i
3. A 7 (
ADDRESS
4. ADDRESS
CONTRALTO R j) 67
i
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
O NEW
❑ BLD.
X ALT.
PLMB.
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
O MECH.
O RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
G
ELECTRIC
WATER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North !South
Size of Parcel
Type Const.
Occupancy
East
Wes
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Location (Area)
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--P/ -1 / SIGNATURE OF APPLICANT
Storage
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil -ng Teghnician
SPECIAL CONDITIONS:
r
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Njpbile Home
Other (Specify)
TOTAL
O.
$ a5: ove'
p
PERMIT NUMMIR
Ot "4S z7Z
03* *2500
* 2500
* 25.006
A *000
427.1 g
05-04-81
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04-81 427.22 *25,OO-
DATE ISSUED
PERMIT NO. TOTAL