1983, 05-25 Permit: 83A-4514 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY --BUILDING CODES DEPARTMENT _4i
el} NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLET NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 0 3 * * 6: 5 0
JOB ADDRfib `, , 0 `0
1 `�j'� aes LEGAL DESCRIPTION — SEE ATTACHED r, ��\* 5 ° 5
LOT BLOC SUBDIV SIO\ PARCEL NUMBER/S
2. 451.3
OWNER r/ PHONE
3.
U' W/[Si-f 5-25-83
ADDRES ,r , p ZIP Actual Set Backs in Feet 6 4 7
e.:7 /j`�1 North 'South East 'West
CONTRA QR ! �' PH 7 f 1 Size of Parcel Zone Classification
I / S / I u4/ -... /
4. ADDRE ZIP Type Const. Occupancy Sprinklered
�� � �
Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
03 * * 6500
CHANGE-OF USE FROM TO Area of Decks Finished Basement Unf in. Basement * 6 5 0 0
6.
TYPE (� No. Baths No. Stories No. Rooms No. of Dwellings n * O.C (..1' 2
NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE.
7. OF ❑ OTHER 4 5 1.f
WORK A BLD. /LPLMB. 0 MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
f of EXEMPTION `' 3
Fi
DESCRIBE WORK t ! c%r Enum. Dist. I Location (Area) FEES COLLECTED 4 7 y
8. PtU.UCLq 6 I
VALUATION SOURCE SOURCE GAS` EL TRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private ❑
in- I 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 presrine
to give authority to violate or cancel the provisions of any other state or local lawr crstruction cstruction yh The
performance of construction.SEE REV$RSE SIDE FOR REQUIRED INSPECTIONS t // Plumbing
/ p r
5''� ..DATE OF APPLICATION 1413 SIGNATURE OF APPLICANT -_ �4 ; ��oil Mech.
SPECIAL APPROVALS / SACIAL CONDITIONS:
NAME DATE � I Plan Check
Env. Health �'""�' (W C". 1 Iii. `r� y
���"``'""'""'''"���� ((/ A. SEPA "_
Planning ! v
:1/70, , cn1
4- ' ,
t Mobile Home - ,,
Fire Marshall , _
P- gekcc
Co. Engineerfr Other(Specify)
Utilities _ 4 I (c./'
`+ d.. �- TOTAL $
Plans Examiner ` 3vA
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist i .. � THIS BECOMES A PERMIT.
t
Building Technician PERMIT IS NONTRANSFERABLE 05,L25 -1.3 4514 °z * 65.0020
-
'9 IC PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL