1981, 04-03 Permit: 81A-3054 Plumbing Fixtures'LAN -1 -UMBER APPLICATION/PERMIT
gSPOKANE 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
1. E. 11S — 35th LEGAL DESCRIPTION — SEE ATTACHED
OWNER PHONE
3 S & A Builders (Rus Smith) 928-0713
ADDRESS ZIP Actual Set Backs in Feet
E. 11117 - 11th, Spokane, Wash. 99206 North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
Miller's Plumbing 483-2025
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
E. 623 Liberty, Spokane, Wash. 99207 ❑Yes [-]No ❑ Reg'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area I Storage
CHANGE OF USE FROM TO Area of Decks I Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
IN NEW E) ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ BLD. IN PLMB. ElMECH. ElM.H. EJ POOL ❑OTHER
WORK CERTIFICATE Req'd. I Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
FEES COLLECTED
8• Plumb'nq installation - New - SFR
VALUATION SOURCE I GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTILOITIES Public ElPrivate ❑
Single $
1 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 law regulating construction or the 64.00
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATF OF APPI ICATInN 04-03-81 SI(-.NATIIRF nF APPI ICANMrti'' /// •Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
16 Fixtures @ $4.00 ea. + $5.00 Permit Fee = $69.00
1) Kitchen sink, 1) Dishwasher, 4) Basins, 4) Toilets,
2) Tubs, 1) Shower, 1) Laundry, 1) Floor drain,
1) Water heater.
ec ni 'an PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
PERMIT NUMBER
brk -
Lv
r, r
G *r.
3u5
Cts—G3—F�1
6.117 9.
Mobile Home
Otpeere(Specify) 5.00
TOTAL $ 69.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 '4+ 0 3 �-�'81 3 0 5 4 5.
DATE ISSUED PERMIT NO.
*69.00 aa.. I-- -
TOTAL