1983, 03-04 Permit: 83A-1520 Plumbing FixturesPLAN NUMBER
l
APPLMATION/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.
0 6 v r
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
1/"at_o;
PHONE
PARCEL NUMBER/S
ADDRESS
ZI P
Actual Set Backs in Feet
North 'South tEast 'West
CONTRACTOR
't!,440 6.1'4 4 -- lira «, 'i -4[, "PCP c_
4. ADDSS
i o3 [_-
DESIGNER
5' ADDRESS
PHONE
g17247e.t3Y07-.7
Size of Parcel I Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area in Sq. Ft.
ZI P
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
❑ NEW
❑ BLD.
El ALT.
0 PLMB.
O AD'N.
O MECH.
O RPL.
O M.H.
❑ MVE.
0 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. is
Enum. Dist.
ILocation (Area) r
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 regulati • cons uction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
3 SIGNATURE OF APPLICANT 41111"
DATE OF APPLICATION
momm
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
-2 44PG
845 i
I/U1
/ Skow CK
1x6456
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
834 /52D
03* *45.00
*45,006
A *0,00 0
151,9g
03-04-83
z 679.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 13I I� D 1 -8.5
•
1520 z
*45.00 -
PERMIT NO. TOT AL_