1983, 01-17 Permit: 83A-0370 Plumbing FixturesPLAN Nl
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
/0s2/- 3 4- 4vQ-cist/Z
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
Gf�o c__F _,q',&
PHONE
#j'It.
PARCEL NUMBER /S
ADDRESS
ZI P
Actual Set Backs in Feet
North !South East (West
4.
CONTRACTOR /'
Gs)O O rw — {4( ra*14UIGfNL,
PHONE
Size of Parcel
Zone Classification
ADD E S
ao3
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE NEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
7, OF '�
WORK ❑ BLD. IdPLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. oZQ Fi
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'd.
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /^ /7-1-3 SIGNATURE OF APPLICANT
SPECIAL AP.'ROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin- echnician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
eg es
TOTAL $
PERMIT NUMBER
03* *85.00
*8500 to-
*85.006
A *000 8
3688
01 -17 -83
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 1 +17 83' 37.02 *85000 J.
DATE ISSUED PERMIT NO. TOTAL