1983, 05-25 Permit: 83A-4512 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
JOB ADDRESS
5-
2.
3.
4.
5.
LOT
BLOCK
OWNER
ADDRESS
CONTRA
ADDRESS
DESIGNE
ADDRESS
3'09 cy
SUBDI ISION
des
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
ZIP
P q**-oi>'I
ZIP
5 9453
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South [East 'West
Size of Parcel 1 Zone Classification
Type Const.
Sprinklered
❑Yes DNo D Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Areaof Decks
Finished Basement
Unfin. Basement
TYPE NEW
9 ALT. 9 AD N. 0 RPL.
7. OF t
WORK BLD. L19.1PLMB. 0 MECH. 0 M.H.
DESCRIBE WORK C
B VALUATION � �t A EL CTRIC
IP 66G
9.
SOUR E
OF _
UTILITIES
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION '
Req'd.
Rec'd.
'Not Req'd.
Enum. Dist. I Location (Area)„
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on revers65ide, and know the same to be true and correct. All provisions of laws and ordinances governir r this
type of work will be complied with whether specified herein or not. The granting of a permit does not . ume
to give authority to violate or cancel the provisions of any other state or local Iaw.tg lating c. tr ctio r the
performance of construction. SI E RE ERSE SIDE FOR REQUIRED (NSPECTIO if
'DATE OF APPLICATION !� / SIGNATURE OF APPLICANT/��
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SP CIAL CONDITIONS:
Eq.)
PERMIT IS NONTRANSFERABLE
l a PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
✓l -151 a_
._03* *41.00
*41.006
A *000
451.1 g
05-25-83
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
o��
•C511:24 *1410'0 a_
:�2 78151
DATE ISS5
UED PERMIT NO. TOTAL