1982, 10-20 Permit: 82A-9878 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 LEGAL DESCRIPTION - SEE ATTACHED
1.r ? v -�3fo
LOT BLOCK + PARCEL NUMBER/S �
2.1_,i yIre:>w.o ow s1
OWNER4 PHONE
3. N ' L-L-i'A Yin S qZ$
ADDRESS pp++ /�� �( ZIP[ Actual Set Backs in Feet
fa C) `P C--�-�� 7`-'�\ -\ % North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
4' ADDRESS ZIPType Const. Occupancy Sprinklered
LP
Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. 1-11
TYPE NEW
No. Baths No. Stories No. Rooms No. of Dwelling
❑ A El AD'N. 1:1 RPL. ❑ MVE.
7. OF ❑ OTHER
WORK El BLD. PLMB. ElMECH. ❑ M.H. ElPOOL CERTIFICATE Req'd. Recd. Not Req'd
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8 L�V� ; ` FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. 1UTILITIEOF
S Public ❑ Private ❑
Single $
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 Building
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 Plumbing
DATE OF APPLICATION 1 �_ _ '2-� Q:/-- SIGNATIIRF OF APPI ICANT�a Mech.
SPECIAL APPROVALS
NAME DATE
iv. Health
anning
re Marshall
:). Engineer
tilities
ans Examiner
=PA Checklist
SPECIAL CONDITIONS:
K��
i of CA+
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONF VFAR FROM DATF OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $-
PERMIT NUMBER
-/0?7-A 9sn8?
�* *21,00
�F7,7
1 -20-R2
4 7 9,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10`2x,_82 98 8z
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