1983, 07-26 Permit: 83A-6957 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: PLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
3 �� LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK BD O PARCEL NUMBER/S
OWNER
3 ADDRE
CONTT
4' ADD S
DESIGNER
5. ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
North South East West
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
113ullcling Area in Sq. Ft.
ZIP I Main Floor I Upper Floors I Garage Area I Storac
PERMIT NUMBER
67 ;2''7-
elk
A &G�
93
!o. 9
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El
WORK 4BLD. lL PLMB. ❑ MECH. ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
/�
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
$ � fr
VALUATION
SOURCE
GAS ELECTRIC
WATER
SEWER
Ownership
1
USE CODE
9.
F
I 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 esume
to give authority to violate or cancel the provisions of any other state or local law r ulating nstructio for the
performance of construction. SEE EV RSE SIDE FOR REQUIRED INSPECTION ;
1
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
S13ECIAL CONDITIONS:
NAME DATE
Env. Health
)
fy�
Y4*,
(
Plan Check
4
L 11�41 ittott � � �i jf�
SEPA
Planning
Mobile Home
Fire Marshall
Ipf�JV\
Co. Engineer
ket-
Other (Specify)
Utilities
1,eo-
j64
TOTAL $
Plans Examiner
�0.
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
Building Technician
PERMIT IS NONTRANSFERABLE
O J
,� 6 9 7 z�-