1983, 03-11 Permit: 83A-1768 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
0.2 ,, .. SPOKANE COUNTY - BUILDING CODES DEPARTMENT _ I 7&
NORTH 811 JEFFERSON / SPOKANE,WAOHINGTON 99260 / (509) 456-3675 elt
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
7/)n `� /� LEGAL DESCRIPTION — SEE ATTACHED
1.
'LOT BLOCK IU
S6IC VISION PARCEL NUMBER/S
2.
OWW PHONE
3.
rrti i 7 J1 ,9,1(102 (j3 * * 16. 0o
Ao9RE55. /) ZIP Actual Set Backs in Feet
5 3/6 2 }orf eC-4. 9?,0, 7 North (South East (West * 1 ci 0 0 Y
CO` ACTOR PHONE Size of Parcel Zone Classification A *a 0 ,Cr:
/riV�i1 �447 �S
4. / �`- l
A)a'p�ESs � k.' 5,34/ ZIP � � Type Const. Occupancy Sprinklered 1 7
Am
Yes 0 No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft. L% % ` 1 1
5. ._ 6Li. 79.
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement ,
6.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF �( ❑ OTHER -
WORK 0 BLD. i/J YLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORKEnum. Dist. 1 Location (Area)
8. x-ix r 5 II FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
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 Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume 04._
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 INSPECTIO A/ Plumbing
( � � l /� Mech.
DATE OF APPLICATION v / 7 /"....? SIGNATURE OF APPLICANT _
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE / /C� ,/`� /� ,20 7�1 )r'� Plan Check
Env. Health �i[ / a:.�y'iW,',rj (141207/701\1/14 fI(J�(//// q�Jf-'��..+
/ SEPA >
CI
Pit
�"� C
Planning / l' /�� C.
!! u
..� Q �-�f Mobile Home
Fire Marshall ,i ) w v -6
LA
Co. Engineer J'' Y Other (Specify)
Utilities
TOTAL $ 1 .`5�
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE
05 1,2.11--83' 176,82 * 16, 00 °
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL