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1981, 11-23 Permit: 81B-2080 Plumbing FixturesPLAN NUMBER 1. 2. APPLICATION/PERMIT SPOKANE COUNTY x BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JOB ADDRESS LOT BLOCK UBDIVISION l //b OWNER 3. Ap D R ESS HONE 91,E, LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S CO CTOR�,,,��``. 4. j+l1�,iV) (� A D ESS DESIGNER 5' ADDRESS /t() L°;A:q �qn�� �j ZIP PHONE Actual Set Backs in Feet North (South Size of Parcel lEast 'West Zone Classification CHANGE OF USE FROM 6. TO ZIP PHONE Type Const. Occupancy ZIP Valuation Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. Main Floor Upper Floors Garage Area Storage Area of Decks Finished Basement Unfin. Basement 7. 8. 9. TYPE OF WORK EW D ALT. ti--PLMB. ❑ BLD. DESCRIBE WORK VALUATION ❑ AD'N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL SOURCE GAS ELECTRIC WATER OF UTILITIES 0 OTHER SEWER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Enum. Dist. ILocation (Area) Ownership Public ❑ Private 0 USE CODE Req'd. 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 perit does not presume to give authority to violate or cancel the provisions of any other state or local law re•.ityfig construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Buildin echnicia SIGNATURE OF APPLICANT SPECIAL CO DITIONS: 1 ,1 6 41/ P6605'© /ac- ERMIIS L, '`,12 1 -11-et NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE Rec'd. Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ l== 2— j PERMIT NUMBER C3* *69.00 *69,00 *69,006 A *0.00 207.92 1 1 -2°3-81 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 1.1-2Y-'81 DATE_ ISSUED 208.02 *69.00° PERMIT NO. TOTAL