1983, 01-31 Permit: 83A-0708 Plumbing FixturesER
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
BLOCK
OWNER
3.
E
c+40 5f4
SUBDIVISION
C c7L -4 j
PHONE
ADDRESS
ZI P
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /5
Actual Set Backs in Feet
North 'South
lEast
West
O RACTOR �J
610 Gti 65.04 -c, /'� c ii!'.l /0-4 G ,
ADDRESS
13(24,3 r /tare SfIt
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
K IN EW
❑ BLD.
PHONE
ZIP
q4 2/
HONE
Size of Parcel
Type Const. I Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
ZIP
TO
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Valuation
Building Area in Sq. Ft.
Main Floor I Upper Floors r Garage Area I Storage
Area of Decks Finished Basement Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8.
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
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 onstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /-3/—r-3 SIGNATURE OF APPLICANT y
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
5:1,14Techwn
SPECIAL CONDITIONS:
4wt
At 6161115.
6IL_4CS
12/55
Sk 0,04-1
W 14
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PEri�'.I I.JMBER
e3N` 0-70e,
03* *85.00
*85.006'
A *0.00 8
'7072
01 —31-83
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'11 - 531-8°.3"
DATE ISSUED
70. 8 z *s5.00°I -
PERMIT NO. TOTAL_