1983, 06-29 Permit: 83A-5942 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 8 3 Pr J 59'4-2.-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
�C ,, APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 0
JOB ADDR S jj /�
1. ,, tt7/We is10100 — (I/I-. LEGAL DESCRIPTION — SEE ATTACHED
LOT BL•CK SUBDIVISN PARCEL NUMBER/S x r 'J
2 OWNS 1 PHONE '
W/i
3. 5o /;, 1
ADDR SSS ZIP Actual Set Backs in Feet
•SS_
iA)ClOO S- North 'Sou.th0
East (West C — c'_ `i•- " 3
CONT A ORJ�`,,s,� PHOp -�[ Size of Parcel Zone Classification
ar.
4. AD SS //// ` 9bZIP/y Type Const. Occupancy Sprinklered
.6 , r Sg7,1 Zb3 Oyes ❑No ❑ Req'd. a
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.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF ��}} ❑ OTHER
WORK BLD. J.PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
11 of EXEMPTION
DESCRIBE WORK ipt 1� Enum.Dist. ILocation (Area)FFLl FEES COLLECTED
VALUATION SOURCE GAS 1 ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 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
type of work will be complied with whether specified herein or not. The grantingof apermit does not Building
yp p p p •sume
to give authority to violate or cancel the provisions of any other state or local law/gulatins •onstructi. .r the
performance of construction.SEE REVE SE SIDE FOR REQUIRED INSPECTIO p / Plumbing
f
DATE OF APPLICATION SIGNATURE OF APPLICANT / �I
•, - Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health L!2r_ _w/c. v/ 'L( t iSEPA +.i
0
Planning /�j� ()
Fire Marshall Mobile Home -i
f*t-'7�c.�i— tr.
Co. Engineer Other(Specify)
kel- Shit*
Utilities
Ikea-W(o/k TOTAL $
Plans Examiner
//�� WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist , F/J THIS BECOMES A PERMIT.
Building Technician FO- PERMIT IS NONTRANSFERABLE0 6 l-•.2'9\-$)3j; 5 9 4`2'z * 4 9• 0'0 a Imo-.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL