1984, 03-21 Permit: 84A-2434 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT peA-A -2_4-
eiNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
�-J
1. c„ c a ^t
LOT BLOCK SUBDIVISION t PARCEL NUMBER/S C v * * - 0
2.
OWNPHONE * 3 f. U 0 X
3. Elbow ail,
ti 9-Zy-AS"'3- H * :
ADDRESS ZIP Actual Set Backs in Feet
- ,V^0 5 4491.2.d LI North (SouthEast (West 2 4 3. ;2.i
CONTRACTOR PHONE Size of Parcel Zone Classification
4. SS , ZIP Type Const. Occupancy Sprinklered C 4 7 C
etV/r,s 1 ' , , a...(./tarAd ,:57d 6 7 Oyes ❑No 0 Req'd.
D SIGNER 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
0 NEW ❑ ALT. JAD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK CIBLD. NPLMB. ClMECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK 4.--. ^ ` i?'% S Enum. Dist. I Location (Area) r
8. (/i/,J GfG-G'�-*� FEES COLLECTED
I
VALUATION SOURCE GAS CTRIC 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 Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume et3
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
a
DATE OF APPLICATION_,...q./-941 ..- / SIGNATURE OF APPLICANT 4 ' ` Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
/ — { SEPA
Planning / — �"' / ____1 .1 _
a.
Fire Marshall Mobile Home w
/ — c:Z.GO; "-
Co. Engineer Other(Specify)
Utilities e� a -
/ — 14/W
4/W TOTAL $ _
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
polo,. ri v/
din chn?(/ PERMIT IS NONTRANSFERABLE 0 '3-21 -8 4 2 4,3 4 z * 3.'0. 0 0-2
LC/c � PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE:ISSUED PERMIT NO. TOTAL