1983, 05-04 Permit: 83A-3619 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY = BUILDiNG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. //5/5' •.-, a e LEGAL DESCRIPTION -SEE ATTACHED
RPHONE
3.
-%'
AD15RESS
ZIP
Actual Set Backs in Feet
North South
East West
C TRACTO
P�101V���
Size of Parcel
Zone Classification
ADDRESS y�j
Q!�G
Type Const.
Occupancy
Sp4.rinklered
❑Yes [-]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Ar;T
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE ,,�, //
L�NEW El ALT. 1-1 AWN. El RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
7, OF�/ �,/ El OTHER
1] OLD. 1r PLMB. ❑ MECH. ❑ M. H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
DESCRJB ORK
Enum. Dist. Location (Area)
FEES COLLECTED
8 /
VALUATION[SUORCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILIT IESI
Public ❑ Private ❑
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions i]orthe
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances govern
type of work will be complied with whether specified herein or not. The granting of a permit does not
Building
to give authority to violate or cancel the provisions of any other state or local law regulati g constructio
c•�
`% '•
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
Mech.
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
3- -,, ade-7s
,5-44-05
1;1,6
1 _ fi: tlJ. T,gN�C
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ J a
PERMIT NUMBER
83 A 75co ►q
f v
f;, 4 i 7.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
C5
05L04_s3' 361.9z
DATE ISSUED PERMIT NO.
45, 0
TOTAL