1981, 02-02 Permit: 81A-1063 Plumbing Fixtures !,-CLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �l �`
t V NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS lJ3 * * 65, 00
1. 6. "7`)() ) I -7,-rf LEGAL DESCRIPTION — SEE ATTACHED * 6 5 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 6 5.O O
2. -
3. OWNER 4A i' �5.N 73 5 E 7(�,U r A *r, 0 0
ADDRESS 1c
Q ZIP Actual Set Backs in Feet 0 6 2
('r' '-5 o I 92-7-6,c, North 'SouthEast West 0 2-0 2-8 1
CONTR CTOR ' , II II PHONE Size of Parcel Zone Classification
U ft-Li iv ii N� b -2 170 g 6 4 7 9.
4' ADDRESS
]] Z P Type Const. Occupancy Sprinklered
DESIGNER ` .---�✓ S PHONE �� Valuation Building❑ ONoArea n S❑q.ReFtc'd
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE � No. Baths No. Stories No. Rooms No. of Dwellings
13 NEW ❑ LT. ❑ AD'N. 0 RPL. El MVE.
7. OF ❑ OTHER
LLL111Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCR BE WORK Enum. Dist. I Location (Area) T FEES COLLECTED
VALUATION SOURCE0,� \Gi 1GAS L,-� iNECTRIC WATER SEWER
8. I r-2 F1-J
Ownership USE CODE
OF
9. UTILITIES Public ❑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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local lawjegulating construction or the �,�
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTION'S Plumbing
DATE OF APPLICATION �-- 4,-- SIGNATURE OF APPLICANT/ ‘-1%7z--4 t/ d" Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE d� Plan Check
�{_
Env. Health VV/ �_t'� vl/�
"F vvV SEPA n_
+ C.)Planning ,J
'Id 1 . W
Fire Marshall 7-1��Q� Mobile Home �..i
Co. Engineer / �'vV� ✓ Other(Specify) L
Utilities I l 1
� (,I TOTAL $ ��'
Plans Examiner K' "
E k lAill':l WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ✓✓VV ( ' I ' ' THIS BECOMES A PERMIT.
1 k . NI
Bui .=`an PERMIT IS NONTRANSFERABLE U'2 -0'2 -'8 1' 1 0 6,3 a *6 5.'0.0 a J _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL