1982, 05-06 Permit: 82A-3540 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
1.
2.
3.
J3B ADDRESS
E, fa/i'7 1 60 At a
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
WOLF
PHONE
PARCEL NUMBER/S
ADDRESS
6-, 19210 De,i141
ZIP
4.
CONTIA.t.CTOR
tie, e/ N
-Pk.G
loo s -
Actual Set Backs in Feet
North 'South [East (West
Size of Parcel
Zone Classification
ADDRE S
3 202
0 t‘rtr.
4
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
AD'N.
0 MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRI E WORK
8. 1.77 AI''
Enum. Dist.
Location (Area)
VALUATION
9./000 o0
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI V -S
(a
DATE OF APPLICATION
SIGNATURE OF APPLICANT
,)14
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ing hnicia
�f
SPECIAL CONDITIONS:
1- eitu.or„
1- To (1Q_r
1- kfv roty
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
!7
$ 17°9
PERMIT NUMBER
33* *17.00
* 1 7.00 1-6
* 17006
A *0.00
35392
05-06-82
z 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01506-82
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUE'_
35402 *17.O0a1
PERMIT NO. TOTAL