1982, 07-14 Permit: 82A-6011 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
1.
LOT
2.
BLOCK
S, /r3 h gla p -c
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWE
a. l 0 r (1 --,0/1•09X)
ADDRESS .- i�
CO' / 1
4. I t/ACTr'OR / �, b.. b, 4ie
AODR S
DESIGNER
5.
PHONE
ZIP
Actual Set Backs in Feet
North (South
East
'West
PHONE
Size of Parcel
Zone Classification
ZIP
ir/ xt)
PHONE
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
1\NEW
0 BLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE.
I*PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
1Y { r �
Pi X '7tL,iC�
ELECTRIC
GAS
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public 0 Private 0
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 regula ing construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
to /rg T
DATE OF APPLICATION
SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CO ITIONS:
NAME DATE Lti/J�
to
Planning
Fire Marsha
Co. Enginee
Env. Heal
Utilities
Plans Examiner
SEPA Checklist
Yeran
Cie
/
1� / »Z L4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check •
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
Sit -(,01 1
03* *181.00
*181.00
A *0.00
601.0
07-14-82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4-A2
8 i2
DATE ISSUED
PERMITN0.1 1 Z *11.8 1.4,01L1.