1982, 09-21 Permit: P82A-8495 Plumbing FixturesPLAN NUMBE R
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
//i/ e
LOT BL_O K SUBDIVISION
OWNER —,
3. , ,i-
ADDRESS
CONTR /A f� j
f .rl � �
4.
ADDRESS / ✓
DESIG R .
5. L /(i fl /W
ADDRESS
3(7/
CHANGE CIF USE FROM
TYPE
7. OF
WORK
NEW
O BLD.
❑ ALT.
PLMB.
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
PHONE
ivd V/
ZIP
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
DESCRIS; WORK
\\ r- tXZc -4 2CS
VALUATIaN
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Actual Set Backs in Fee
North South
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
Upper Floors
Ea st
West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Area of Decks
No. Baths
Finished Basement
Storage
Unfin. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Req'd
Rec'd.
Not Req'd.
Ownership
Public ❑ Private ❑
Location (Area)
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 ar the
performance c f construction. SEE REV RSE 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
Building Te nic Ian
SP CIAL CONDITIONS:
jar . F /o-at ,1) /(41 >„
f . /i, (4 Pool u
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
4q.c
$
PERMIT NUMBER
03* *49.00
*49006
A *0,00
849,42
09 -21 -82
z 6,479,
RECEIVED
iiitit#AW! COW) EtWhttil
ISEP2I X982
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9, '21
DATE ISSUED PERMIT NO. TOTAL
82 849,52 *49,00