1981, 02-09 Permit: P81A-1306 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
1.
2.
JOB ADDRESS
//7/_5
LOT BLOCK SUBDIVISION
Lti /221_14,
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
PHONE
PARCEL NUMBER/S
ADDRESS
CONTRACTOR (� i i
4. ADDRESS V A//)4•J
DESIGNER ,,
5' ADDRESS
ZIP
PHONE
Actual Set Backs in Feet
North 1South 1East 'West
71
Size of Parcel 1 Zone Classification
ZI•
2'4; . )
PHONE
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
gis<
IV EW ❑ ALT. ❑ AD'N. ❑ RPL. D MVE.
BLD. KPLMB. ❑ MECH. 0 M.H. 0 POOL
DESCRIBE WORK(
8. � y( 7„tirn
VALUATION
9.
SOURCE
OF
UTILITIES
0 OTHER
GAS N ELECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private 0
Location (Area)
USE CODE
Req'd.
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
2-9- -/
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
1-/ 4
I 'rJW _
1 1 Ai-irJOR`rt 1 -Ori
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
03* *49,00
*i "100
*4.9,00
A *000 E
1305
02-09-81
6479,
vl1`c-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02 09.-81
13a6z *49.0.02F -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL