1981, 04-20 Permit: 81A-3724 Plumbing Fixtures rAN
NUMBER • APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
5iA -3-7Z4k-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDR SS5 �, C° C
1. ^� F / Til LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 57.00
O W N EO' f (���II/�/� /j Al ONE E
`� .),44, 17-em,,... , % b-.3, A .k f; n C t.'
3
ADDR ZIP Actual Set Backs in Feet ' r'
Ti--_ S 3 r ! North 'South East (West
0 TRA TO PHON Size of Parcel Zone Classification 0 It--2 0-81
4' AD222ESS ba(o-s(,0a Type Const. Occupancy Sprinklered 6 47 r
u / 3 49to1 Dyes ❑No D Req'd.
G
DE NER l� 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
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHERCERTIFICATE Req'd. Recd. Not Req'd.
WORK /1-4.1zw.BLDLMB. 0 MECH. ❑ M.H. 0 POOL
of EXEMPTION
DESCRIBE WORK Enum.Dist. ILocation (Area) ` FEES COLLECTED
8. i3 tiikT s I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑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 c.ncel the provisions of any other state or local I., resulting construction or the 13 62,f.-`'performance of construction.SE REVE- E SIDE FOR REQUIRED INSPECT'• •j• Plumbing
�•
DATE OF APPLICATION / / SIGNATURE OF APPLICANT +444111 Mech.
SPECIAL APPROVALS ' SPECIAL CONDITIONS:
NAME DATE .. Plan Check
/ ) - 1� aDA.,2
Env. Health r --col (�
SEPA >
� 2
Planning .$ _ .j i1
J
i
Fire Marshallf 71, Mobile Home `
-
y
Co. Engineer C S'/.t,r.k/ Other(Specify) ,
Utilities / 1/Ir
` �1 1 I TOTAL $
Plans Examiner I 1 [/LYJ// -
` WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 1 L.. )41,s-v'to THIS BECOMES A PERMIT.
ilding •
� Technician PERMIT IS NONTRANSFERABLE 0 141I-12jO - 1.' 3 7 24 Z *'5 7.0 0 a IJ- ,
/j- I4 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL