1982, 10-07 Permit: 82A-9209 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
el/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISIO PARCEL NUMBER/S * I 5, 0 0 Y
� L^
2.
OWNS PAiI „.
3 /At4.` 4yo C-04,s f•
C' � Q
8
ZIPAq Actual Set Backs in Feet
ADDR ``— ,7. 8 2
�d i >!v mkt)04,0 / I�� North (South East (West I e
CON ACTOR PHONE Size of Parcel Zone Classification E 6. 7
5P4E,4` Are.el 4 L t k/ „r.r.c_ q.? 3S/3
4. ADDRESS ZI / Type Const. Occupancy Sprinklered
/.3 3 Si. Fast rr04- 7i7! 6 Dyes ❑No 0 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. No.Baths No. Stories No. Rooms No. of Dwellings
TYPENEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 0 BLD. PLMB. 0 MECH. 0 M.H. 0 POOL
of EXEMPTION
DESCRIBE WORKEnum.Dist. I Location (Area) FEES COLLECTED
8. D Fisc. FEES
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES i Public El Private 0 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 i�
to give authority to violate or cancel the provisions of any other state or local law •• .ting construction or the Ifperformance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO;t, Plumbing ,
Air
AP
DATE OF APPLICATION AV74Z' SIGNATURE OF APPLICAN / •
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: Plan Check
NAME DATE
Env. Health 9C.4)C.
SEPA t>
/��� C C.-)
planning 145
y u� Mobile Home _IFire Marshall ts..
l 54esev e-' Other (Specify)
Co. Engineer / i,4/• c
Utilities I X4-514 TOTAL $ l'�+'
Plans Examiner iI F O,
IWHEN MACHINE VALIDATED IN THIS SPACE,
✓�'1L�1�. THIS BECOMES A PERMIT.
SEPA Checklist
ldiinn echnifcia PERMIT IS NONTRANSFERABLE 1 0 -07 -6"2 9 2 0,9 z * 4 5.0 0 2 h.
� � PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL