1983, 01-06 Permit: 83A-0097 Plumbing FixturesPLAN NUMBER APPLICATION/ PERMIT
PERMIT NUMBER
SPOKANE COUNTY — BUt%o:lh*,3 CODES DEPARTMENT^
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS //y// f.aC )11� LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK PARCEL NUMBER/S
ISUBDIVISION
2. I
OWNER L� R PHONE
3
ADDRESS ZIP Actual Set Backs in Feet
North South East West
7J * * 4 5.0 0
CORACTOR PHONE Size of Parcel Zone Classification
* 4 5. 00c')
�`o �e .S il�'Caf4UlG�1� .iuC- 9P
4' ADDREZIP Type Const. I Occupancy Sprinklered
A * C 0 0 3
�''+�
W-.214 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
Q (�
5.
ADDRESS ZIP Main Floor Upper Floors Garage Ar;T Storage
6.479,
CHANGE OF USE FROM TO Area of Decks I Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ALIEW E) ALT. 1:1 AD'N. 1:1 RPL. El MVE.
ElOTHER
7, OFrra�yy E&P
❑ BLD. E&PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK Enum. Dist, Location (Area)
FEES COLLECTED
�D rl,<Tvt -
8. S
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTILOtTIES Public ❑ Private ❑
I Single $
1 hereby certify that I have read and examined this application and have read the "IVsions included
_
on reverse side, and know the same to be true and correct. All provisions of lawsgoverning this Building
type of work will be complied with whether specified herein or not. The grantings not presumeto
give authority to violate or cancel the provisions of any other state or local lawruction or the ys�
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION Plumbing
DATE OF APPLICATION ! 'CO — k,5 SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
cci
Env. Health �
SEPA
}
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
/
Utilities
��
TOTA L $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
�rj�rtf+ldi PERMIT IS NONTRANSFERABLE 0,, q -.0 6'- t 1
9.7 z * 4 5. 0 0 a �.
n ec can
q
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT NO. TOTAL