1982, 12-17 Permit: 82B-2011 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
JOB ADDRESS
1. (b/9' , i/C-
LOT B OCK S BDIVI ION
2
OWNER
3.
ADDRESS
-93/ /7(elJf!
CONT ,ACTO '' !�%
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
9.
PHONE
ZIP
ZI P
PHONE
ZIP
TO
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
BLD.PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
/0
VALUATION
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North
Size of Parcel
Type Const.
South East
Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
SOURCE
OF
UTILITIES
GAS
WATER
SEWER
Storage
Unfin. Basement
No. Rooms
No. of Dwellings
Req'd. Rec'd.
Location (Area)
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 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 .ulating construction or e
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO r.
4 14. �1 L. ���iY - fi /
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health'
Planning
Fire Marshall
Co. Engineer
Utilities
SIGNATURE OF APPLICANT
PEC AL CONDITIONS:
Plans Examiner
SEPA Checklist
l it t PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
Gi 2 . - 4 ) t
03* *45,00
*45.008
A *000 8
201.02
12 -17 -82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,2;17' -82' 20L1Z *45.000 —
DATE ISSUED PERMIT NO. TOTAL