1981, 08-07 Permit: P81A-7886 Plumbing FixturesAPPLICATION/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
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK SUBDIVISION
PARCEL NUMBER/S
OWNER
3.2N �:afJ Ati
ADDRESS
• 5 1'� CA N ‘O#V
CONTRACTOR
4. £ Uv�a..uc.
ADDRESS
toe
DESIGNER
5. ADDRESS
PHONE
ZIP
C -464.7 -CD
PHONE
Actual Set Backs in Feet
North
Size of Parcel
South
East West
Zone Classification
ZIP
ct�t7rz�#•
PHONE
Type Const.
Occupancy
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floo
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
YJ NEW
❑ BLD.
❑ ALT.
PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 14' F IXTuRES
VALUATION SOURCE GAS
OF
9. UTILITIES
Enum. Dist. I Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private ❑
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_ O _-_ -. __6 -..�._ SIGNATURE OF APPLICANT (� � X76_
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
V.S. SiAti .
4 LAU tS
?AM Sin,t4
1 ` (A,\, 3 P, Pc_
1 TVLt3
t CLCXJa D .A'i Ai
Nzv & fi
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing 6:1.C7C"
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ( a�
PERMIT NUMBER
OjiYr 1£Y&)(..
03* *61.00
*61.00 '
*61.006
A *000
788.52
08-07-81
2 679,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0 8 —JO '7 8` 1
788.62
DATE ISSUED PERMIT NO.
*61.00ag
TOTA L