1982, 06-22 Permit: 82A-5222 Plumbing FixturesIPLAN NUMBER
I'"
APPLIC\�TION/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.
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK SUBDIVISION
PARCEL NUMBER/S
OWNER
3. I I/1/ 41-s#r 1 COvred to 7ic>'J
ADDRESS
PHONE
ZIP
4.
CORACTOR
49040 -See g—• ktew1.•f445
P/ I'7.3si ,y
Actual Set Backs in Feet
North !South [East (West
Size of Parcel 1 Zone Classification
ADD E S
2103 E Ax4-4- r s�-
Z oi.
Type Const.
Occupancy
Sprinklered
DYes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
ANEW 0 ALT. ❑ AD'N. ❑ RPL. 0 MVE.
0 BLD. ❑oPCMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. /O Fi,c i...s'f
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 44 'GO 2 .Q 7."" SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
4.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ‘rS1**'
L
PERMIT NUMBER
-
03* *45.00
*45.006
A *000
5221g
06-22-82
2 647'9.
a.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06:-92.2-8.2 52222
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE nnTF Iccl IFn
*4500 -
PCRrAIT MC TATO!
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