1982, 10-12 Permit: 82A-9400 Plumbing FixturesPLAN NUMBER APPLICATION' 'PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
fi NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
CO -QR�
JOB AD RESS
/�17/6 41!5*- Ve/0
Size of Parcel
LEGAL DESCRIPTION —SEE ATTACHED
~
LOT
BLOCK
UBDIVI ION
4. ADp nES S
�y D E
PARCEL NUMBER/S
2.
Occupancy
I
DESIGNER
PHONE
Valuation
OV�G� W
3.
RMONE
ADffESSActual
5' ADDRESS
Set Backs in Feet
Main Floor
Upper Floors I
p (�../
C7/
North South East West
CO -QR�
ONE
Size of Parcel
Zone Classification
~
Co. Engineer
Utilities
Plans Examiner
4. ADp nES S
�y D E
P
Type Const.
Occupancy
Sprinklered
❑Yes [:]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors I
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
8,,,7AD'N.
TYPE`AD• ❑
No. Baths
N o. Stories
No. Rooms
No. of Dwellings
❑ NEW ❑ALT. L1-1 RPL. MVE.
7, OF❑ OTHER
1:1BLD. 1P'1LMB. ❑ MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DIE=;; 0 K O
Enum. Dist. Location (Area)
FEES COLLECTED
8.
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑Private El
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 granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
17 929
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
Mech.
DATE OF APPLICATION " "` SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
SPECIAL CONDITIONS:
'� �Q �
*/,—/Env.
1 r L�o-�
Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
o-6 (
03* * 1 7.00
939,9
10-12-82
6.479.
,s
TOTAL $ �7
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 12-82 940.025
DATE ISSUED PERMIT NO
*17,OOafj-
TOTAL