1982, 07-14 Permit: 82A-6013 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
JOB ADDRESS
LOT
2.
BLOCK
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SUBDI I C ON
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CONTRACTOR )
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4' ADDRESS
F' y
DESIGNER
5.
6.
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
llu�=t;
PARCEL NUMBER/S
ZIP
PHONE
';WT X')<
Actual Set Backs in Feet
North 'South `East 'West
Size of Parcel Zone Classification
ZIP
PHONE
Type Const.
Occupancy
Sprinklered
El Yes El No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors I Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin, Basement
TYPE
7. OF
WORK
8.
9.
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H. 0 POOL
DESCRIBE WORK
VALUATION
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
X'ilk.i'r
Enum. Dist. I Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 9
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 INSPECTION
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✓`_7 SIGNATURE OF APPLICANT
DATE OF APPLICATION
SPE%IAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil Tec
SPECIAL CONDITIONS:
/,� -.
-I/- 6Lo2v eis
'-
5' -e12_4.)
- a6h40e61 , r
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
0A
03* * 1 81.00
* 1 81.006
A *0.00
601,2
07-14-82
g 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07i-1'4_'82 601,32 *'181.00'2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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