1981, 03-25 Permit: 81A-2742 Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT g31 'Z74-Z
LA' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS „ 1 2.O O
1. _. L�)(7 I f LEG,3L DESCRIPTION - SEE ATTACHED * 1 L
LOT BLOCK SUBDIVISION 0 0 u)
PARCEL NUMBER/S
2. * 12.006
OWNER PHONE
3. VI u .b A * 0. 0 0 23
ADDRESS"s7( /�s,� ,^, ZIP Actual Set Backs in Feet 27 4 1 z
l ` ' W Vl —(� North (South East (West
CONTRACTOR PH NE Size of Parcel Zone Classification 0 3-2 5 8 1
ADDRESS4. -
6.4 7 9.
C71
C.
ZAP Type Const. Occupancy Sprinklered
7 t ) r1 QomJ4- `t'i 04, Dyes ❑No ❑ Req'd.
DESIGNER T PHONE STT 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.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE
❑ NEW .� ALT. ❑ AD'N. D RPL. El MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. IM MECH. 1=1M.H. ElPOOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
8.QDESCRIBE WORK Enum. Dist. Location (Area) ' FEES COLLECTED
.'u.2•a..x�2sz., '�.e.�V2.s' /(:).-,2)--,A._. A--C .-
VALUATION SOURCE �G/AS ELECTRIC r WATER SEWER Ownership USE CODE
9. UTILITIES /\ X Public D 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 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.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION r) ) .r 3 ) SIGNATURE OF APPLICANT ,)Lk- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning C
C
_ C
Fire Marshall Mobile Home
?IP EN& ONLY
Co. Engineer Other(Specify)
Utilities
TOTAL $ f
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building hniiccian PERMIT IS NONTRANSFERABLE 0?3'i-'�1'�• ���l� ') 7 4'Z'oZ * l 0 a H -
t9 T PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL