1982, 10-04 Permit: P82A-9044 Plumbing FixturesPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
3.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRES
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LOT BL CK SUBDIVI ION PARCEL NUMBER /S
OWNER
ADDRESS
CONTRASTONC67),"
4.
ADDRES T
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DESIGN
ADDRESS
V
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PHONE
ZIP
PHONE
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LEGAL DESCRIPTION - SEE ATTACHED
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
LLL NEW
.BLD.
❑ ALT.
❑ PLMB.
ZIP
TO
❑ AD'N.
❑ MECH.
DESCRIBE WORK
8. 1 P x ila°...)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Actual Set Backs in Feet
North
South
Size of Parcel
Type Const.
Occupancy
East 'West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Upper Floors Garage Area
Finished Basement Unfin. Basement
No. Stories
Area of Decks
No. Baths
Storage
CERTIFICATE
of EXEMPTION
No. Rooms
No. of Dwellings
Req'd. Rec'd.
ELECTRIC
WATER
SEWER
Enum. Dist.
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 pre me
to give authority to violate or cancel the provisions of any other state or local law reg lating construction o the
performance of construction. SEE REVE'SE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION // !7-'" SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
(4.zy4.
/)s F62
111 /eAD
le I v
gr
' 7 r
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
$ '� v.......-
,70
PERMIT NUMBER
03* *49.00
*49.006
A *0.00 8
90432
10 -04 -82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 0 4' -8 -2
DATE ISSUED
90442 *49.00°
PERMIT NO. TOTAL