1982, 04-27 Permit: 82A-3198 Plumbing FixturesPLAN NUMBER
J
APPLICATION/PERMIT
SPOKANE COUNTY - BUILIiNG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JADDRESS
1. /(-7
L T
2.
BLO K
u.�d01d
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
AD RESS
CONTRACTOR C Vv./ rim' --Qr
4. ,S ,Fe;E` `inn j�iY 1, .S cis rAtc
ADD 7E 4.:� L� 7 9 / .pJLL
5.
DESIGNER
P ONE
5N �
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
(West
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Eves ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
8.
9.
lg NEW
❑ BLD.
DESCRIBE WORK
VALUATION
❑ ALT. ❑ AD'N.
PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
❑ MVE.
❑ POOL
WATER
❑ OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private ❑
Location (Area)
USE CODE
Req'd.
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 -iexptresume
to give authority to violate or cancel the provisions of any other state or local law gulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
SIGNATURE OF APPLICANT / C
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
Building Tech
PERMIT IS NONTRANSFERABLE
PERMIT EXRIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
— AAech.
Plan Check
SEPA
Mobile Home
1,(2Loy_
'G'C/
Other (Specify) '
TOTAL
$ S 6'0
P
PERMIT NUMBER
03* *45.00
* 4500 th-
* 45,006
A *0.00 8
319,7E04-27-82
s 6.479.
h
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04-27-82
DATE ISSUED
319.82 *45,OOa1-
PERMIT NO. TOTAL