1981, 08-24 Permit: 81A-8475 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.
3.
4.
JOB ADDRESS
LOT BLO SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
5.
O NE
q4
ADDRESS;
CONTRACT R
C)
PHONE
ADDRESS.
9 1-PJJ5
DESIGNER
PHONE
pP,
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
East
West
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors l Garage Area
Storage
6.
CHANGE OF USE FROM
�%
LJ NEW
0 BLD.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ LT. ❑ AD N. 0 RPL. 0 MVE.
0 OTHER
PLMB. 0 MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORr4
8.
Enum. Dist. I Location (Area)
VALJATION
9.
SOURCE
OF
UTILITIES
GAS ELECTRIC
WATE R
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 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 [i' C 8'1 SIGNATURE OF APPLICANTS
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
din 7ri�ian
SPECIAL CONDITIONS:
ULA .
ri,A L914,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT tUMBE
84-715
03* *4500
*45.00
A *0.00 `3
847.4
08-24-81
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
;01.81-42 4 _ 8 1'
DATE ISSUED
847,5'2
PERMIT NO.
*45,002. -
TOTAL