1982, 11-03 Permit: 82B-0516 Plumbing Fixtures1PLAN NUMBER
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
2.
3.
LOT
BLOCK
/00I rL (L
SUBDI I ION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
PHONE
PARCEL NUMBER /S
ADDRESS
ZI P
Actual Set Backs in Feet
North 'South
East
West
4.
CONT I /f ry ,4t
A.c. /
PHONE
Size of Parcel
Zone Classification
ADDRESS
DES NE
5. 1 CJ $ fit
ACP RESS
CHANGE OF USE FROM
6.
ZI P
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
11'4-17
Valuation
Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
8.
TYPE
OF
WORK
NEW
BLD.
DESCRIBE WORK
VALUATION
9.
❑ryry ALT.
PLMB.
❑ AD'N.
❑ MECH.
SOURC E
OF
UTILITIES
GAS
❑ RPL. ❑ MVE.
1=1 OTHER
❑ M.H. ❑ POOL
.7- /L S. / /.e4.
ELECTRIC
WATER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Req'd.
Not Req'd.
SEWER
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 riot. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law re•ulating construction or e
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
!ding lj'echnic'an
SPECIAL CONDITIONS:
%a - Tie
PA{ - 52911(etn.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
1 J *
* 49,00
* 49,006
*000
51,52
11 -03 -82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11. -03 =82
DATE ISSUED
51,6z
PERMIT NO.
*49.00ak. —
TOTAL