1982, 11-15 Permit: 82B-0999 Plumbing Fixtures(PLAN NUMBER
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cy
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
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LOT
BLOCK
3
OWNER
SUBDIVISION
5),4-s) 6T,C 5'L't
ADDRESS
4.
CONTR TOR
te Sf'�
ADDRESS
/ 02-0Y
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZI P
PHONE
Z1Q 2 C
PHONE
ZIP
TO
Kd'NEW 0ALT. ❑ AD'N. 0 RPL. ❑ MVE.
❑ BLD. CJ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
/D rfx1vG5"5
GAS
ELECTRIC
WATE R
SEWER
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
No. Baths
Upper Floors
Sprinklered
❑Yes ONO ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Req'd.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 APPLICATION ` [5 S Z SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
On
clan_
SPECIAL CONDITIONS:
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1344 alis
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PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing r6
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
Qcici
03* *4500
*45.006
A *0,00 8
9982.
11-15-82
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
L11-15 82 99.95 *45.004 -
DATE ISSUED
PERMIT NO. TOTAL