1983, 03-11 Permit: 83A-1738 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BOILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
LOT BLOCK
2.
OWNER
S, wG C/Rcrj2
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
3. G ? S, (70.c,67-
ADDRESS
1 � 5;1_,,
HONE
PARCEL NUMBER/S
ZI P
Actual Set Backs in Feet
North 'South [East 'West
CONTRACTOR
4.
76R2S
<-7•6 /../ 4 L/‘
DESIGNER
5. ADDRESS
PHONE
-4/ 934r 7/
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin_ Basement
TYPE
7. OF
WORK
[LKEW ❑ T. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD.MB. ❑ MECH. ❑ 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.
DESCRIBER /
8. cr i /5i
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
L Unum. Dist.
S
Location (Area)
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 'r/74 SIGNATURE OF APPLICANT ✓
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CON%TIONS:
t
/_ 7-e, Z.
/-
,—/e.�/
rte/ G C..- G /ice p
/- i7/. -td
/A./
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 5` 070
PERMIT NUMBER
7"314
03*
A
17372
*5600
*5600
*56.006
*000
03-11-83
z 64~79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.3 1-83' 173851 *56.00211' -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
›-
a-
WHEN
-