1981, 05-27 Permit App: 81A-5140 Move SinkPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NL4 9ER
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NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3.
4.
6.
OWNER
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AD RESS
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CONTAACTOR, �l
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DESIGNER
ADDRESS
CHANGE OF USE FROM
TO
P ONE
c)2 /*,2
ZIP
PHONE
ZIP
gy1/
PHONE
ZIP
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
East
West
Zone Classification
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
TYPE
7. OF
WORK
8.
❑ NEW KALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. -PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
VALUATION
9.
;OURCE
OF
UTILITIES
GAS
I
'/ 1Z-..r-
ELECTRIC
WATER
0 OTHER
Area of Decks
No. Baths
Finished Basement
Storage
Unfin. Basemen
No. Stories
No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist. !Location (Area)
Req'd.
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,nd 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 regylating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
6/ec4?/
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
No. of Dwellings
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
9,60
03* *9.00
*9.00
*9,006
A *0,00
51 3.9z
05-27-81
g 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PI r rnPV
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
05.-27.-.81
DATE ISSUED
5140z *9.00a_I
PFRMIT Nfl
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