1982, 10-28 Permit: 82B-0343 SinksPLAN NUMBER
f �
C./
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 956-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.5- 13217 [O
LOT BLOCK SUBDIVISION
2.
OWN R
3.
LEGAL DESCRIPTION — SEE ATTACHED
ADD 3 ESS
b� CKopiAl 1%5.947 f criff
CONTR/{CTOR
4.�
ADDRESS
PHONE
22' 2— ---734
�19y�
PARCEL NUMBER/5
Actual SH Backs in Feet
North (South East (West
PHONE
Size of Parcel Zone Classification
ZIP
Type Const.
Occupancy Sprinklered
Elves LINO ❑ Reced.
5
DESIGNER
PHONE
Valuation
Building Area 1 Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
G NEW�E ALT. 0 AD N. El RPL. 0 MVE.
Lel
❑ BLD. CMB. 0 MECH. El M.H. E POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. 0 Dwellings
CERTIFICATE
of EXEMPTION
Reg'd.
Rec'd.
Not Rena.
DESCRIBE WORK
8
Enum. Dist.
Location (Ar a)
VALUATION
9.
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
ownership
Public ❑ Private ❑
USE CODE
I hereby certify that I have read and ex mined 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 0/ i 2 SIGNATURE OF APPLICANT et
SPECIAL APPROVALS S ECTAL CONDITIONS:
NAME DATE ..7..... ' ES
Env. Health1 NI
Planning
Fire Marsnall
Co. Engin
Utlli
,ans Exannn
EPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
S' gI $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
I3
TOTAL $
PERMIT NUMBER
/ c. -LIS -C'.4.5
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-28.-82
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
343° *13.002
PERMIT NO. TOTAL.