1982, 12-17 Permit: 82B-2013 Plumbing FixturesPLAN 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
2.
JOB AD >ESS 6/96)
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LOT L CK SUB 'VISION
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C LEGAL DESCRIPTION - SEE ATTACHED
�LJ / t PARCEL NUMBER /S
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ADD FS' S Y / 31
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CON. ACT R
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DESIGNER
5. ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
North 'South
East
'West
PHONE
Size of Parcel
Zone Classification
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
BLD.
8.
9.
DESCRIBE WORK
!/
VALUATION
❑ ALT.
74 PLMB.
Pik
❑ AD'N. ❑ RPL.
❑ MECH.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
Ownership
Public ❑ Private ❑
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
ordinances governing this
permit does not pre e
lating co r truction r, he
on reverse side, and know the same to be true and correct. All provisions of laws an
type of work will be complied with whether specified herein or not. The granting of,
to give authority to violate or cancel the provisions of any other state or local law re .
performance of construction. SEE REVERS SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPEC.AL APPROVALS SPECIAL CONDITIONS:
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
NAME DATE
Plans Examiner
SEPA Checklist
Z wfL
(rev -S
'
1- 'id--
(I 7
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
- X13
03* *4'9.00
*49,006
A *0.00
201.2-2
12 -17 -82
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
2'0L3z *49.0Oa17-1; -
PERMIT NO. TOTAL