1982, 07-09 Permit: 82A-5862 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
JOBAADDRESS l LEGAL DESCRIPTION — SEE ATTACHED
1. ,
L B O K ISLIBIIIV1510N PARCEL NUMBER/S
2.
Oyrf R NJ
3.
AD KESS _ — // i �� .
7`
ZIP
Actual Set Backs in Feet
North South
East West
CONTRACTO
PIAONE
�ASS
Size of Parcel Zone Classification
r7DR
4.
Z P
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPENEW ❑ ALT. ❑ AD' N. ❑ RPL. 11 MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellinc
], OF ElBLD. XPLMB. 1-1 MECH. ElM.H. El POOL ❑OTHER
WORK
CERTIFICATE
Req'd.
Rec'd.
Not Req'c
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist.
Location (Area)
8.
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
Public El Private ❑Inuded
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisio
on reverse side, and know the same to be true and correct. All provisions of laws and ordinanc
type of work will becomplied with whether specified herein or not. The granting of a pe It does nto
Building
give authority to violate or cancel the provisions of any other state or local law regula n strucperformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS )Plumbing
DATE OF APPLICATION // -7SIGNATURE
Mech.
OF APPLICANT
SPECIAL APPROVALS
NAME DATE
nning
e Mar
neer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
stAi
v 4
�✓�- t� = PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
s
Other (Specify) ..
TOTAL $�,��
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERVIT.
PERMIT NUMBER
G/ 1
3* *69.00
*69,006)
Q sF 0 ``,
J
6479.
SPACE,
5'86.2 z
*6 9,0 0 a; -