1981, 02-27 Permit P9-81A-1871 Plumbing FixturesAPPLICATION/PERMIT
SPOKANE COUNTY —'BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
/d % i8 er'icier Pot_
LOT BLOCK SUBDIVISION
3.
OWNER
ADDRESS
rGN yr �kl 4C-i
CONTRACTO»
!, d 49 Sews . /Icc y itijresg L'
ADDRE
ly
2--03 C #tAr rsr-
DESIGNER
5.
ADDRESS
PHONE
ZI P
PHONE
9..k3y33
ZIP
a y.2/G
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East (West
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation I Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
✓<.YIVEW ❑ ALT. D AD'N. ❑ RPL. ❑ MVE.
El BLD. 4LMB. ❑ MECH. D M.H. ❑ POOL
El OTHER
D SCRIBE WORK n
8. p,� t 4 �CC� �tJA1// /
VA U TION SOURCE GAS ELE TR W TER
OF
9. UTILITIES
WER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑Private ❑
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 permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regul. ' g con ruction 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
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
Rec'd-
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing 47.
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
03* *61.00
*61.00
*61,006
A *0.00
187.02
0'2-27-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Gil G rnav
Building Technic n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0 '2;r% 2 '? — 8 18 7: 1 z *6 10 0 1—
DATE ISSUED PERMIT NO. TOTAL