1982, 01-11 Permit: 82A-202 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT f37-1X - 02—
e/ NORTH 811 JEFFERSON / SPOKANWASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
G3 * * 1700
JOB ADDRESS
1. S, 3 �0 \-
� ��.�� LEGAL DESCRIPTION — SEE ATTACHED * 1 c U,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 1 -z v 0
2. OWNER PHONE A it G c F
3. 6E4, �s Ci.3 i/ G 0 1
ADDRESS 1 .ZIP Actual Set Backs in Feet
; ''. ...&1C, �-‘c: -LC, (4=1-D—c',C. North 'SouthEast (West C 1 — 1 1 '-8, 2
CONTRACTOR PHONE Size of Parcel Zone Classification
4.
Gee., YA 1�1-1 G.ta SMB c�...5(� "---- --1.‘ <%e 6 L1 / 9.
ADDRESS ZIP Type Const. Occupancy Sprinklered
N , I4-►ct (.....C-n-- c''Ci-20` _ ❑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.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
❑ NSW ❑ ALT. ❑ AD'N. IZIRPL. ❑ MVE.
7, OF ❑ OTHER -
WORK
0 BLD. PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTI LOITIES, 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 granting of a permit does not presume Building
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 Plumbing 413 -C•
•
DATE OF APPLICATION'?J1"l tJs. SIGNATURE OF APPLICANT444-7277:27-4-44-1(Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: _
NAME DATE ` �t� (.-mer— - Plan Check
Env. Health .-pIp�
1 JT(ily
SEPA
Planning
n
Fire Marshall Mobile Home _1
u_
Co. Engineer Other (Specify)
Utilities
TOTAL $ l* ,C..
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
®' ing Technician { PERMIT IS NONTRANSFERABLE 0` '.',111�r-`8 2 2 0.2 °z' * 1 3.0.0 °a'F
� ., C . �y PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL