1982, 10-04 Permit: 82A-9050 Plumbing FixturesiltilPLAN NUMBER
APPLICATIQN/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
r JOB ADDRESS 7
1. 'l: Cu
LOT BLOCK—SUBDIVISO
2
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
PHONE
PARCEL NUMBER/5
ADDRESS
ZIP
CONTRA
t/ (lT w
ADDRE
PHONE
Actual Set Backs In Feet
North (South [East (Wes
Size of Parcel
Zone Classification
ZIP
Type Const
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
DESIGN
5. ADORE
6.
� k P664147
6.4 301
CHANGE OF USE FROM
PHON
Valuation
Building Area in Sq. F
TO
ZIP •^
WafP2[l
Main Floo
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basemen
TYPE
7. OF
WORK
.LT NEW 0 ALT. 0 AD N. 0 RPL. O MVE.
0 BLD. -a PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Bath
No. Store es
No. Room
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
of Req'd.
DESCRIBE WORK
8. ri,?C'fU�
VALUATION SOURCE GAS ELECTRIC
OF
9. UTILITIES
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public 0 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 re eating construct' °?I or the
performance of construction. SEE REVERSE IDE$FOR REQUIRED INSPECTIONS,% / r
DATE OF APPLICATION / J 1 /O ✓ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
SPECIAL CONDITIONS:
zea -tojc_
Aws
fro ir-q-Pr
f-sLiu'7.
kti ILA'
144, .,
i.Qx FS,
leu'AS
k eta .
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
03* *49.00
*49.008
A *G00
90492
10-04-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES -A PERMIT.
;. I It
14.`;.,0
DATE ISSUED
,
905,05 *49.00°i
PERMIT NO. ' TOTAL