1983, 02-03 Permit: 83A-803 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT UMBER
0) SPOKANE COUNTY — BUILDING CODES DEPARTMENT C
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
-1673
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. //7/0 i.6---et LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
MNER PHONE
3. rr 1116,01 I1 54 ) /-u,t-e6 X.R lye _ C 3.* * 1 7.0 0
ADDRESS ZIP ' Actual Set Backs in Feet
�/' �� ♦Q`C� North (South East IWest * 1 7. 0 0
�TRACTOR f 1't'/( c�- PHGSNE Size of Parcel Zone Classification
K• ✓�r C1',,4jr0 /rayl.b ice* ;0 � 2 . * ,a
4• —sDRvx bvi Zip Type Const. Occupancy Sprinklered .
rte) ��/C nT 3QC. =`
��0 Dyes ❑No ❑ Req'd.
n
DESIGNER PHONE Valuation Building Area in Sq. Ft. 0 %- 0 3-8 3
5. G 7 9
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF ��(( ❑ OTHER
WORK 0 BLD. PLMB. ❑ MECH. Ci M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
8. `� .x /�t- s I FEES COLLECTED
�f I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 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
to give authority to violate or cancel the provisions of any other state or local law r•.'ul. ing construction or the 47
/0
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONf Plumbing
DATE OF APPLICATION0 °`- SIGNATURE OF APPLICANT . ' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: /
NAME DATE /)) 1 ,/ l Plan Check
Env. Health > 6GL f7;�r]e- r
!/(�(/ SEPA
a
Planning 0
/ h t/ _ ca
Mobile Home W
J
Fire Marshall
LL
/
e7'� Other (Specify)
Co. Engineer
1
1 /
Utilities TOTAL $ /2e3P
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Builds , echnici. i PERMIT IS NONTRANSFERABLE 0,2. 0 Y.—'8 5 8 0. 3'z * 1 7, 0 0 2 —
J PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. . TOTAL _