1982, 07-13 Permit: 82A-5946 Plumbing Fixtures(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
JOB ADDRESS
1.
LOT
2.
BLOCK
SUBDIVISION
I 13ifL-Cr
OWNE 1 i?"�f
Q t�
3 ?
ACQDRESS;
(111 iA-f
COI,J,ACTOR / iJ
i e7
AffESS . ,
4.
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ZIP
4, '/
Actual Set Backs in Feet
North 'South East (West
PHQNE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
rJ. ADDRESS
PHONE
Valuation Building Area in Sq. Ft.
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
t[VEW
❑ BLD.
❑ ALT.
❑•PLM B.
O AD'N.
❑ MECH.
O RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
ILocation (Area)
Ownership
Public ❑ Private D
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 INSPECT!C
/�.
DATE OF APPLICATION ..>� SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
5-4)�
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
/c(
PERMIT NUMBER
03* * 1 81.00
* 1 81.006
A *0.00
59452
07-13-82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ft7- B:2. 5'9465 *181:,0021
DATE I$SUE' PERMIT NO3. TOTAL