1981, 09-08 Permit: 81A-8970 Plumbing FixturesPLAN NUMB,:R
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
V APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. K. 11n05 3"7 -TI♦ AV LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK SUB I I ION I PARCEL NUMBER/S
OWNER
A5 !S NOIAP-'S
PHONE
0126•- e
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3. NAILH
-"
1
ADDRESS
ZIP
Actual Set Backs in Feet
F• 11-712— IMPO
D6
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
ALP1NF- ?LWIM131N
Z2��-Ola$'
a.
ADDRESS
ZIPType
Const.
Sprinklered
P.0 a ;Z Z-3 NKE- >
o�
TOccupancy
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
I Garage Area
Storage
CHANGE OF USE FROM
Area of Decks
Finished Basement
Unfin. Basement
TTO
6.
TYPE �,/
0 NEW ❑ALT. El AD'N. El RPL. 11 MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF ��� ❑ OTHER
❑ BLD. FI LMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK !1 S
i'L
8. 1,11vW P IT FI1C`tltiL
Enum. Dist.
Location (Area) FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public El Private ❑
I I
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
Building
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 00
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTMS Plumbing
OF �i SIGNATURE OF J::�&
DATE APPLICATION -j- APPLICA .Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
I•
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
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1
SHowr��:-
KI � sink.
j
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Muir- Amm
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify) J
ZC s
I
TOTAL $ 1 -vx
PERMIT NUMBER
8/A - PT -70
03* *4900
*4900
*49.006
A*0..00
8969
09-0<8-81
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`g -i0 a 81 8 9'T z
DATE ISSUED PERMIT NO.
*49,00?) -
TOTAL
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