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1981, 03-20 Permit P81A-2608 Plumbing FixturesPLAN NUMBER —1 APPLICATION/PERMIT )4) 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. 5. JOB ADDRESS LOT BLOCK OWN ZIL £ /t6 06 rr -4 prSUBDIVION AIESS "R IO) i:;- t- c-r fir: CON ACTOR PH" Pitt.04,64 PD ss� L ry, e4x HI/ DESIGNER ZIP 72(6 PHONE 53619Y76 ZIP PHONE LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North -1South East West Size of Parcel Zone Classification Type Const. Valuation Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO [VEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ BLD. ILMB. ❑ MECH. ❑ M.H. 0 POOL 0 OTHER Area of Decks No. Baths Finished Basement No. Stories No. Rooms Unfin. Basement No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8. VALUATION 9. SOURCE OF UTILITIES AS ELECTRIC WATER SEWER Enum. Dist. Location (Area) 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 grantins of a permit does not presume to give authority to violate or cancel the provisions of any other state or local I.,� elating construction or the performance of construction. SEE '7REVERSE SIDE FOR REQUIRED INSPECT!I DATE OF APPLICATION (1/!/..._____ SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CO(VDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing ‘,'Of/ Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBFR l(on? 03* *69,00 *69,00 N *69.006 A *0,00 260,72 03-20-81 z 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. .03-2Q-81 26O.85 DATE ISSUED PERMIT NO. *69.00 TOTAL