1983, 01-06 Permit: 83A-101 Plumbing FixturesL
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
LOT
2.
/j'/7-/q v4cr
BLOCK
SUBDIVISION
3
OWNER
ADDRESS
4.
CONTRACTOR
Ciao 64 <5f4 -c. /f11CX'4wc.ogii fac
ADDRES�D�
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
9'07 /,G
PHONE
ZIP
TO
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. iljspLMB. ❑ MECH. ❑ M.H. ❑ POOL
El OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
'East West
Zone Classification
Sprinklered
Dyes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. %C-4(
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATE R
SEWER
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Req'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 regulatin construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION )� 1 " SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
cf 239s, )5
OZ %rte l
a- S /D .c5
44/4-soil.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
g4s,-OJal
03* *8500
*85.006
A *0,00 8
10.02
0'1 -06 -83
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,1- 06 -`83.
DATE ISSUED
10.12
PERMIT NO.
*85.00a�.
TOTAL