1982, 10-21 Permit: 82A-9910 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY --BUILDING BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
J 6 ADDR SS ,
,(,►� LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK ISUBDivisiuN PARCEL NUMBER/S
2.
OWNER..� PHONE
3. �✓
ADDRESS ZIP Actual Set Backs in Feet
North South East West
CO TRACTOR
At RAIZ>�,
PH NE
Size of Parcel
Zone Classification
4' DDRESS
Type Con;q
Occupancy
Sprinklered
v
03
❑Yes []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.
TYPE ,� �
No. Baths
No. Stories
No. Rooms
No. of Dwellings
lif"NEW F-1 ALT. El AD'N. C3 RPL. El MVE.
7, OF ❑ OTHER
—Tot
1:1 BLD. CMB. ❑ MECH. ElM.H. [3 POOL
CERTIFICATE
Req'd.
Rec'd.
Req'd.
WORK
of EXEMPTION
DESCRIBE WO_ftK
�
Enum. Dist.
Location (Area)
FEES COLLECTED
8 � �
VALUATION
OU
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
1UTILVES
Public ❑ Private ❑
Single $
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
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
_37,
Plumbing
147— /O 7 45raC Ao�Mach.
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
T,
SPECIAL CONDITIONS:
�i4vr
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $�
PERMIT NUMBER
7, l 0
* n'CY
Q
67r
r
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1!0`-21 99100
*37.00° -
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