1983, 01-31 Permit: 83A-0710 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
el SPOKANE COUNTY =.1BI,GILDING CODES DEPARTMENT
NORTH
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 1. `' j)
1/�J' fy UAfri iti4e ,4- LEGAL DESCRIPTION — SEE ATTACHED 0 v * * 4 g 0 p
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * i G 0 0
V
2.
OWNER PHONE A * 0. C. c S'
3. //4 %e--( e4 7/,
ADDRESS ZIP Actual Set Backs in Feet 7 0 O
North 'SouthEast 'West 0 1 -3 1 -8 3
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
/3,320-3 F t `•c.0 s5/#"... q:57 /6' Oyes ❑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 11;1'1NEW ❑ ALT. D AD'N. ❑ RPL. 0 MVE.
7, OF 0 OTHER
WORK 0 BLD. l=1.-PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK �� �nEnum. Dist. Location (Area) v
8. /C i, FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC 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
to give authority to violate or cancel the provisions of any other state or local law regul. construction or the /�l�``�
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing 7/
DATE OF APPLICATION "r'3(` 5'i SIGNATURE OF APPLICANT," -./_ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health,
SEPA >-
Planning4, CD
Fire Marshall
I r-'51 Mobile Home `
IS4dw Fr:
Co. Engineer ( ehthe Other (Specify) /
Utilities �
�
� TOTAL $ %7�
Plans Examiner / Ft-)
fj (,mfr{ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
din Techni ian PERMIT IS NONTRANSFERABLE01-'3 1 8'''3 7 10 z *4 9.0 0 0 i _
(.51
5.. PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL