1982, 10-04 Permit: 82A-9052 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
1.
LOT
2.
BLOCK
SUBD I5ION
3.
OWNER
PHONE
LEGAL DESCRIPTION --SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
4.
CONTRACT
ADDRESS
5.
DESIGNER
ADDRESS
unci a4 4070
k lc's P/t,,,Qi4py.
.6.4
CHANGE OF USE OM
6.
TYPE
7. OF
WORK
TO
ZI P
Actual Set Backs In Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ZIP
Type Const.
Occupancy
Sprinklerod
❑Yes UNo 0 Req'd.
°M.--07.1/
Valuation 1 Building Area In Sq. Ft.
ZI10 6
Main Floor
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfln. Basement
NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 OTHER
BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
DESCRIBE WIT t ' L _
8. I ��� K�?,J
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
NO. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
.of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
ELECTRIC
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 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 reg ating construction •r the
performance of construction. SEE REVER SIDE FOR REQUIRED INSPECTIONS /
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co- Engineer
Utilities
Plans Examin
SEPA Checklls
Bu dtling3Tsohh i ciyn
Z SIGNATURE OF APPLICANT
SPEC AL CONDITIONS:
'—"cc - CG1lC'.. 1 f
1
,.- drA6 let . F O.
(e :-�� i' `A.p.
(moi-
((rt. I� - 5 t��A(.Qq.
4•
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
l e'v
03* *49.00
*49.00'6
A • - *0.00 8
. 90512
10-04-82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
AnnJ
THIS BECOMES A PERMIT. 0
DATE ISSUED PERMIT NO. TOTAL