1981, 09-22 Permit: P81A-9656 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
UBDI V ISION
2.
OWNER.
3. K0`/ I',, d.-4.12il>'f >
ADDRESS
C= A4CO ACTOR
4'TyDRESS
DESIGNER
5. ADDRESS
PONE ,-)��/r'
IP/
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
'''31-527-,61
ZIP
ar
Actual Set Backs in Feet
North 'South
Size of Parcel
Type Const.
East 'West
Occupancy
Zone Classification
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
PERMIT NUMBER
GJ* *49,00
*49.00
*49006
A *0,00
965.52 ;lop
0i-22-81
2 6479
Area Storage
t Unfin. Basement
No. of Dwellings
Not Req'd.
FEES COLLECTED
Finished Basement
EW ❑ ALT. ❑ AD'N. ❑ RPL. 1=1 MVE.
❑ BLD. IPLMB. ❑ MECH. ❑ M.H. D POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
f(1C—(Lg.
Enum. Dist.
Location (Area)
no -
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ 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 pe it does not presume
to give authority to violate or cancel the provisions of any other state or local law reg j�g constructip or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
9/07 //
V DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building_Technician
s. 4J
SPECIAL CONDITIONS:
I-
e. L4CiXCf
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Single $
Building �f �/
DPlumbing 19' C
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Oda -22`-81 96565 *49.002172
DATE ISSUED
PERMIT NO. TOTAL
CII C rnov