1982, 11-01 Permit: 82B-0482 Plumbing FixturesLAN NUMBER
I
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
� �
ADDRESS
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
Garage Area
JOB ADDRESS
CHANGE OF USE FROM
LEGAL DESCRIPTION — SEE ATTACHED
Area of Decks
LOT
Unfin. Basement
SUBDTVISION
PARCEL NUMBER/S
2.
1--BLUEK
No. of Dwellings
No. Baths
OW ER
A
PHONE
], OF OTHER
❑ BLD. �PLMB. ❑ MECH. ❑ M.H. ❑POOL
CERTIFICATE
— �.
Recd.
3.
WORK
of EXEMPTION
I
ADDRESSZ
DESCRIBE WORK
Enum. Dist.
21P
Actual Set Backs in Feet
1d
NorthSouth
East West
SOURCE
CONTRACTOR
ELECTRIC
WATER
PHONE
Size of Parcel
Zone Classification
9.
Y
L
a 7J
ADDRESS -*'ZIP
Single $
Type Const.
Occupancy
Sprinklered
�QG O
�yy
9 ems®
Dyes ❑No ❑ Req -d.
1
DESIGNER
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
PHONE
Valuation
Building Area in Sq. Ft.
PERMIT NUMBER
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ADDRESS
ZIP
Main Floor Upper
Floors I
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
No. Rooms
No. of Dwellings
No. Baths
No. Stories
TYPE NEW ❑ALT. 11 AD'N. 11 RPL. ❑ MVE,
], OF OTHER
❑ BLD. �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. C2-- �l -A'
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
UTILOITIES
Public ❑Private ElJI
Single $
/
1 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
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
11--4-2 X
Mech.
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
1111- l -r _Z1 $1
NAME DATE
s7L
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Plan Check
Env. Health
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SEPA
Planning
'3 Loa�J`S
Fire Marshall
_f.��ls
Mobile Home
Co. Engineer
l-�Olt�ExL-
Other (Specify)
.A
Utilities
E,�GTO�
TOTAL s6-3-(250
Plans Examiner
Plans
WHEN MACHINE VALIDATED IN THIS SPACE, '
SEPA Checklist
THIS BECOMES A PERMIT.
Building Tachnician,,,
PERMIT IS NONTRANSFERABLE
1'!]. 0 8 2 4 6. 2 z
*5300a�