1982, 05-20 Permit: 82A-3965 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 8-214r s 3�‘5
• J NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
\v'�J APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JQB ADDRESS iJ { * * 4 J: 0 0
1. �(/-� 1331--7 4_114 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOC SUBDIVISION PARCEL NUMBER/S * ' 5. 0 0 v
2. * 4500Y
OWNER PHONE
3. • --ii i' }{ - -itiA7- A * G 0 14
ADDRESS GI�Pq Actual Set Backs in Feet
PC) — 13 6 I / / 21 North (South East 'West J y "
Y�
CONTRACT D R PHONE Size of Parcel Zone Classification o 5_2 0 2
4.
ADDRES ZIP Type Const. Occupancy Sprinklered _ b 7 9
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE �// No.Baths No. Stories No. Rooms No. of Dwellings
I� NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF ,rte ❑ OTHER
WORK ❑ BLD. 0 PLMB. ❑ MECH. CJ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Dist. Location (Area) FEES COLLECTED
8. 10 1,014 P5I►J 61 rix, `ice
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public ❑Private 0 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
type of work will be complied with whether specified herein or not. The grantin•.. =mit does not pr-:,,me Building
to give authority to violate or cancel the provisions of any other state or local law re_ m••-•= ctio • the -T-(_5
performance of construction.SEE REVERSE SIDE FOR REQUIR I i, • ►.►1 bi I I I I I I I I I I I I I I I I Ibi Plumbing
DATE OF APPLICATION t3 —(7 _,73 - r Al/�►
SIGNATURE OF A• e ,=_" i _� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: -
NAME DATE / Plan Check
Env. Health 2 G
Planning l ' `I� 5f a- SEPA j
L
c_.)l (106 —
Fire Marshall Mobile Home a
Co. Engineer -6.15 Other (Specify)
Utilities L
TOTAL $ 4.ç
Plans Examiner l / .
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buil Tech . ian PERMIT IS NONTRANSFERABLE 0.5 4 0 --'8'2 3 9•6 5.z *4 5 0 0..°
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL