1982, 06-29 Permit: 82A-5537 Plumbing Fixtures1
PLAN 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
2.
LOT
BLOCK
X32
SUBDIVISIO
OWNER �)),17217?—,'"7-t?'
3 F` ie.; 1 e4., il)i.54-A,o..
ADDRESS
/9
✓
CONTR- TOR .— T %,,4, IPC /
LEGAL DESCRIPTION - SEE ATTACHED
4.
ADDR S� `/, (-.5(C('1/
DESIGNER
PHONE
PARCEL NUMBER/S
ZIP
Actual Set Backs in Feet
North 'South
PHONE.
, .,/..16 lzj
East
West
Size of Parcel I Zone Classification
z12
927
PHONE
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd.
Valuation (Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors
6.
CHANGE OF USE FROM
TO
Area of Decks
Garage Area
Finished Basement
Storage
Unfin. Basement
TYPE
7, OF
WORK
NEW
❑ BLD.
❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
EtPLMB. 0 MECH. 0 M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8.
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
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 regu.ati g construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 6 �-=�-�� SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building hn
SPECIAL CON ITIONS:
</j
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Req'd.
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMJT NUMBER.
' 2-A,'7 1
U3* * 1 81,00
* 1 81.006
A *0,00
553.62
06-29-82
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-712,9- 78 2,
DATE ISSUED
5 5:3,7 Z * 18].0 0 ° —
PERMIT NO. TOTAL