HomeMy WebLinkAbout1982, 10-04 Permit: 82A-9042 Plumbing Fixtures(PLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
1.
2.
3.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADD ESS •
1STOG ArfieS
LOT LOCK SUBDIVISION
OWNER
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
ADDRESS
4.
5.
CONT
`AC OR
�N �(!
re`s �u
ADfQ SSfx 377/
CHANGE OF USE FROM
DE
ZIP
Actual Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
6.
TYPE
7. OF
WORK
PHONE
Z12
71)7c
Valuation (Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
14 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
CBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESCRIBE W J11 j/ r M is /�i j' �
8. \G
VALUATION
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
WATER
SEWER
Enum. Dist. I 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 regulating construction o the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL \PPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
0
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
zy
1 FA
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
03* *4900
*49,006
A *000
9041R
10- 04-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1f0r04782
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
904•2g *49,00,2
PERMIT NO. TOTAL