1981, 06-15 Permit: 81A-5925 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT t
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1 JOB DD / Q LEGAL DESCRIPTION - SEE ATTACHED 0 3 * * 2 5.0 0
LO , OC SUBDIVI ON PARCEL NUMBER/S * 2 5.0 0 ti
2. * 25006
3. owNNriYPHONE
n1 a2S J-E_Y- 721-5S gg A * 0.00 g
ADDRESSf-L ZIP Actual Set Backs in Feet 5 9 2 G g
F / �) North (South East (west
CONTRACTOR r PHONE Size of Parcel Zone Classification 0 6- 1 5-8 1
4. 7 _
Eitz ke Aly 1ses 921-?'042 6479
ADDRE$SV U 7 E — Tve /� L ZIP_ l z O� Type Const. Occupancy ❑Yes ❑No kl
Sprinered
[[ 0 Req'd.
DESIGNER/ 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 0 NEW KALI. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. XPLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORKEnum. Dist. Location (Area) r—
$ �� `� / I FEES COLLECTED
VALUATION SOURCE GASELECT/�C WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private D 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 ordi es gove ,ing this
type of work will be complied with whether specified herein or not. The granting of a p- it does not s esume Building
to give authority to violate or cancel the provisions of any other state or local law regula.i • co truction . the , 00
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS APlumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT A_ �' Mech.
SPECIAL APPROVAL PECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
3 7 1-3`e_ S/ Pr
SEPA >._
Planning
—
Fire Marshall . Mobile Home a
Co. Engineer - 616
E 1---c-
c-( J _,1 - Other (Specify) �`
Utilities /�
1 -- 14//We ec't � TOTAL $2—S•e'd
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
4 4 ,> ' , .
i Buildin• ian PERMIT IS NONTRANSFERABLE 0 5. 8 1 5'9 2.5i *2 5 �'U a F. -
— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE-ISS ED PERMIT N
41 O. TOTAL
•_ - 1