1982, 07-27 Permit: 82A-6446 Plumbing FixturesaER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
✓ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. lovii —+c-1
LOT
BLOCK
2.
- -�,
OWNER
1- C `EL_WW
3. --
ADDRESS
CONTRACTOR
Ire l��ra`Dr�
4.
ADDRESS
Co. Engineer
DESIGNER
5. ADDRESS
SUB I I PARCEL NUMBER /S
-T >%.AA«OCIV
CHANGE OF USE FROM
6.
PHONE
-Pt a6 -24.4
ZIP
G4 Zoa
PHONE
ZIP
a -c;k-VC7
PHONE
NG*
TYPE NEW ❑ ALT. ❑ AD-N. ❑ RPL. ❑ MVE.
7, OF
WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER CERTIFICATE Req'd. I Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. 2 ?, F \ C—C L�QC5;
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9, IES
Public 11 Private ❑
UTILIT
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
Actual Set Backs in Feet
- -�,
NAME DATE
North South
East
West
Size of Parcel
Zone Classification
e77
4 14'26R2y
1!.r��.Vfz V-\tN5
Co. Engineer
Utilities
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
❑ OTHER CERTIFICATE Req'd. I Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. 2 ?, F \ C—C L�QC5;
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9, IES
Public 11 Private ❑
UTILIT
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
-rok
- -�,
NAME DATE
TLALas
L ALL,
Env. Health
Planning(
°'T
Fire Marshall
4 14'26R2y
1!.r��.Vfz V-\tN5
Co. Engineer
Utilities
s Examiner
Single $
Building
Plumbing ) 7,
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
03* *117.00
*117,00
A *00 0 n
644,52
07 -27 -82
;? 6479.
TOTAL $ � t7- I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.chnician PERMIT IS NONTRANSFERABLE I U �71- �,�'.7 -12 6 4 16 2 *�l ��,'7 0 0 u0. IJ-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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