1981, 05-13 Permit P81A-4653 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
3
4.
6.
JOB ADDRESS
OT
OW
[ 0
BLOCK
ADDRESS
CONTRACTO
7TJ.
AVE$S® 7
DESIGNER
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
ci
SUtSUIVISIUN
CHANGE OF USE FROM
TYPE
7. OF
WORK
XNEW
❑ BLD.
DESCRIBE WORK
8. 3 Z. ElX-fut%ES
VALUATION
9.
❑ ALT.
J(PLMB.
SOURCE
OF
UTILITIES
GAS
❑ AD N.
O MECH.
❑ RPL.
❑ M.H.
ELECTRIC
P 6ONE
-2D4Z
gz-46
PHONE
❑ MVE.
❑ POOL
WATER
❑ OTHER
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
Occupancy
Main Floor Upper Floors
Area of Decks
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
Finished Basement
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public O Private 0
Location (Area)
Unfin. Basement
No. Rooms No. of Dwellings
Req'd. Rec'd.
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 •:- not resume
to give authority to violate orcancel the provisions of any other state or local law regula1 n% o structio;�,,
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION t•-54
! l
SIGNATURE OF APPLICANT f
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B Idi g Technician
SPECIAL CONDITIONS:
ram,)-s
TodeiS
ays
q— s(ACks'
4
4 —
gei — W rt!-e,a' thzei 1-trS
_7- p ya't' Ls
z.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Do
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
o
/2 .p
Other (Specify) ' LI (3
PeYMt
0 C.
TOTAL $ /3 m,
PERMIT NUMBER
03* *13300
* 1 33.00 N
* 1 33,006
A *0,00 8
465.2
05-13-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
5��„,11!3 'gs11
DATE ISSUED
1
4 6 5.31 *11'3 3, 0'0 i _
PERMIT NO.
TOTAL
TJUS 131-IWG
SAWS OWef;�/6UL-0P LD
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OAV4ATUM
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7
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