1981, 03-09 Permit: P81A-2190 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASIII`IGTON 99260 / 1509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
4.
JOB ADDRESS
5.
LOT
01i
A
BLOCK
1G�91 •—.3j
SVBUIIVI ION
CONTRACT
T loo (JL
Q /1/
-La — K471,--/7)2 S20 7
aci
ADDRESS
DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
9r -17,r
PHONE
C1-'7/
PHONE
PARCEL NUMBER/S
Actual Sot Backs in Feet
North [South
East (West
SprinklereD
Oyes ONo 0 Recl d.
Azo of Parcel Zone Classification
Typo Const.
Occupancy
Valuation Building Area In So. Ft.
ADDRESS
ZIP
Main Floor
UDDer Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPErN. EW O ALT. 0 AD N.
7. OF /1
WORK 0 BLD. PLMB. 0 MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Roq'd.
RDc'd.
Not Req'd.
8.
DESCRIBE WORK
G
VALUATION
9.
SOURCE
OF
UTILITIES
tELECTRIC
GAS
Enum. Dist.
Location (Area)
ATER
SEWER
Ownership
Public O Private 0
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 INSPECT I j S
DATE OF APPLICATION / Cr/ SIGNATURE OF APPLIC
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DA Ft
Env. Health
Boning
ire Marsna
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
FEES COLLECTED
Single S
Building
Plumbing
PERMIT IS NONTRANSFERABLE
T.
Plan Check
SEPA
Mobile Home
Other (Specify)
ul
TOTAL S�
PERMIT NUMBER
03* *500
*5.0.0
*5006
A *000
21898
03-09-81
R 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03-09-81
219.08 *5.00V
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO, IOTA!.