1982, 12-10 Permit: P82B-1792 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
1.
JOB ADDRESS
/0e 11 AvcvstA
LEGAL DESCRIPTION — SEE ATTACHED
2.
LOT
BLOCK
SUBDIVISION
3.
OWNER
�QLF'- Z
PHONE
PARCEL NUMBER /S
ADDRESS
ZIP
Actual Set Backs in Feet
North 'South LEast 'West
4.
CONTRACTOR
ADDRcS� ^�
DESIGNER
P9 HONE
5%23
Size of Parcel
Zone Classification
ZIP
gl.02/
Type Const.
Occupancy
Sprinklered
❑Yes ❑NO ❑ Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
1NEW
❑ BLD.
❑ ALT. ❑ AD'N.
t PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories No. Rooms
No. of Dwellings
8.
DESCRIBE WORK
A/ KTI✓A
CERTIFICATE Req'd.
of EXEMPTION
Enum. Dist. I Location (Area)
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATE R
SEWER
Ownership
Public ❑ Private ❑
USE CODE
9.
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 re construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /v l SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
T-'65
v_ $114sexis
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PERMIT IS NONTRANSFERABLE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
03* *8500
*85,006
A *000 8
1'79, 1
12 -10 -82
22 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,7- 10 -:82 179.2,5 *185,002 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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