1981, 06-05 Permit: 81A-5536 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
JOB ADDRESS
-�� LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLTK fSUtSUFVIS10N I PARCEL NUMBER/ -1,
OWNERy i 0 h4
PHONE
3.
ESS
ZIP
Actual Set Backs in Feet
North South East West
CON RAC OR
PHONE
Size of Parcel
Zone Classification
4.
ADORE
ZIP
Type Const. I
Occupancy
Sprinklered
d�
❑Yes [-]No ❑ Req'd.
DESIGNER
P NE
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.
TYPENEW ALT. ❑ AD'N. El RPL. 11 MVE.
❑
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7. OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
WORK
I
of EXEMPTION
DESCRIBE WOR
Enum. Dist.
Location (Area)
$ �l
41
FEES COLLECTED
VALUATIONVALUATIONI
SOURCE GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑ Private ❑
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Single $
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_
—161AV
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing ��
DATE OF APPLICATION , — S' �/ SIGNATURE OF APPLICA L�
Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health 'h
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS: ?
Plan Check
�fJ J..✓ftl�c Lz- SEPA
Mobile Home
Other (Specify)
n. PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $
P
PERiCIT NUNEER
8 VP,- - SS 41
C3 *45.00
*!(c v0 u
*45,00
A *0 0, 0
y535�
0'6-05--81
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
io 8! 1;
5 5 16 iZ
DATE ISSUED PERMIT NO.
* 4 5.tq .-j