1983, 05-23 Permit: 83A-4392 Plumbing FixturesJOB ADDRESS
1.
LOT BLOC
2.
OWNER
3.
ADDRESS
CONT ACT
I
4' ADD E S /f
DESIGNER h��
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
191w R iDIQr� /
1ISG LEGAL DESCRIPTION — SEE ATTACHED
�
NE
ZIP
Actual Set B
North
PHONE
Size of Parcel
ZIP
Type Const
PHONE
Valuation
in Feet
Zone Classification
pancy Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Stora
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Base
6.
TYPE
No. Baths
No. Stories
No. Rooms
No. of Dv
EW
❑ALT.
❑ AD -N. 1-1 RPL.
❑ MVE.
7, OF
rBLD.
PLMB.
❑ MECH. ❑ M.H.
❑ OTHER
❑ POOL
CERTIFICATE
Req'd.
Recd.
Not
WORK
of EXEMPTION
DESCRIBE WORK
i
Enum Dist Location (Area)
8 FEES COLLECTED
r
VALUATION I SOURCE AS EL CTRIC WATER SEWER Ownership USE CODE
9. UTILOITIES 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 pre me
to give authority to violate or cancel the provisions of any other state or local I regulating nstruction the
performance of construction. SEE E ERSE SIDE FOR REQUIRED INSPECTI Plumbing
Mech.
DATE OF APPLICATION /143 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health /�
SEPA
Planning
PERMIT NUMBER
- 3
OSA $29,00
* 0 0
A * 'n 5
n
gs � y '7 `r
_ !
i
Fire Marshall k
R)lG,Mobile Home
11 I Co. Engineer %�.Other (Specify)Utilities ,X
f�l TOTAL $_jZj__
Plans Examiner
IV�1J\ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ( THIS BECOMES A PERMIT.
uil T e. ni n PERMIT IS NONTRANSFERABLE 0, L.2'-8` 3' (iR 3 9, 2 z.
*29,OOaF