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1983, 11-04 Permit: 83B-1287 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / W.SHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES JOB ADDRESS 1. S '37 CS— LOT 2. BLOCK tt, t SUBDIVISION OWNER 3. 14 : fYi L'hl ADDRESS G. 3 _'S CiSti LEGAL DESCRIPTION — SEE ATTACHED PHONE a"� i77i PARCEL NUMBER/S ZI P Actual Set Backs in Feet North 'South (East 'West 4. CRNTRACTORn �1L 'YLatrvtelk, A DINESS PHONE 7 •7 Z. Size of Parcel 1 Zone Classification 1 a: t.� �► 114 S ; C.3t4I >fl ZI P 71;er y: Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. 5. DESIGNER PHONE Valuation (Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors r Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK ENEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE N. 8. VALUATION 9. OL K SOURC GAS OF UTILITIES Enum. Dist. Location (Area) ELECTRIC WATER SEWER Ownership Public ❑ Private ❑ USE CODE 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 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 DATE OF APPLICATION 1 i ) 3 / �i 3 SIGNATURE OF APPLICANT �i� ►l,�l� SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist i S et S'A•., 1" I)) Vnl 1— W 'A"5 Oiage. PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 65 PERMIT NUMBER (13. ►z7 03* *6500 *65006 A *0.00 S 128.62 1-1 -04-83 2 6479, WHEN MACHI ffVALIDATED IN THIS SPACE, THIS BECOME A PERMIT. 1:1—*04�±^ET5' PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 128.7z PERMIT NO. *65,00°1 TOTAL