1982, 10-07 Permit: 82A-9211 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
1.
2.
3
JOB ADDRESS
•>. /02 o 7 e3oK1.00 JcL
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
ADDRESS
30/0 W • 644 s et)
4.
CONTRACTOR�•
C�acO 51r4 t /reams.) 'cos t-,S4,e.,
Zc q. y
9F. 3e/
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
East
'West
Size of Parcel
Zone Classification
Alda �3 Fdctrf r
2y9ai6
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
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
Unf in. Basement
TYPE
7. OF
WORK
Id -NEW 0 ALT.
0 BLD. &PLM B.
❑ AD N. 0 RPL. 0 MVE.
❑ MECH. ❑ 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
/>(7vcl3
ELECTRIC
GAS
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
1 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 INSPECTIONS
DATE OF APPLICATION7/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NtME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BulIdin• Technician
a.we
2 '"/S.
1 SI ✓/\
MO
1
.5404)0•C
I. 4o)Ct-
I. Ca 4.
1 ell Ld-j'
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
/ea.
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$1f
PERMIT NUMBER.
62 Pt - qzt\
03* *41.00
*41,006
A *000
9.21.08
10-07-82
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1I 7i. 1`
1D.,0„81+' 2
DATE ISSUED
9`2 ).1z
PERMIT NO.
*4100'2g. -
TOTAL