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