1983, 04-25 Permit: 83A-3299 Plumbing FixturesNUMBER APPLICATION/!HERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUM
k / `0 n ,6
o
5. ADDRESS
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
Storage
,, ,Q
LEGAL DESCRIPTION —SEE ATTACHED
1
I
LOT
BLOCK-
PARCEL NUMBER/S
2.
I
Finished Basement
Unfin. Basement
OWNER
6
.
PHONE
3
TYPE 15� NEW ALT. AD'N. 11 RPL. MVE.
❑ ❑ ❑
DDRESS
I
No. of Dwellings
ZIP
Actual Set Backs in Feet
7, OF / OTHER
❑ BLD. X.PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
North South
East West
C ACTOR
WORK
of EXEMPTION
P ONE
Size of Parcel
Zone Classification
N
Enum. Dist,
Location (Area)
FEES COLLECTED
4. A
8 � �
Zlp
Type Const.
Occupancy
Sprinklered
VALUATION
SOURCE
GAS
ELECTRIC
WATER
Dyes ❑No ❑ Req'd.
DESIGNER
Pri ONE
Valuation
Building Area in Sq. Ft.
PERMIT NUM
k / `0 n ,6
o
5. ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
,, ,Q
_
I
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
r2 v
6
TYPE 15� NEW ALT. AD'N. 11 RPL. MVE.
❑ ❑ ❑
No. Baths No. Stories
No. Rooms
No. of Dwellings
-=
7, OF / OTHER
❑ BLD. X.PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK •
Enum. Dist,
Location (Area)
FEES COLLECTED
8 � �
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
9.
UTILOITIES
I
Public ❑ Private ❑
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provision
_
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances goveBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does noto
Inh
give authority to violate or cancelthe provisions of any other state or local law regulating constructL
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
Plumbing
DATE OF APPLICATION La SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
7
�
Plan Check
Env. Health
/ r
J e
SEPA
Planning
Y .// / )�
�ff�JG�(J•,CIJ'+L
Fire Marshall
�1
Mobile Home
—
Co. Engineer
— � J)
/ JIGS
Other (Specify)
Utilities
/'� d S KC
t
�J,
TOTAL $
Plans Examiner
Q /=7�
/
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
/ — �'/QD j !�
/
THIS BECOMES A PERMIT.
0 �' 2 5,:-- 8` 3 3�'2 9. 9
*45.0' �, a H
.Tec an PERMIT IS NONTRANSFERABLE
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