1982, 06-04 Permit: P82A-4524 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUIL D17IG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. - U.
- LEGAL DESCRIPTION -SEE ATTACHED
-
LOT
BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNE
PHONE
^
3.
ADDRESS48V
ZIP
eC,
Actual Set Backs in Feet
,-( �1✓North
South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.RESS
zip
Type Const.
Occupancy
Sprinklered
GCds j
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
No. Baths
No. Stories
No. Rooms
No.•of Dwellings
TYPE � NEW ❑ALT. ❑ AD'N. I–]RPL. 1:1MVE.
7, OF ❑ OTHER
EI BLD. �I PLMB. 13MECH. ElM.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
8 �a��
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
P
Public El Private ❑
Single $
1 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 regulating construction or the
c1�
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
DATE OF APPLICATION [p1✓�SIGNATURE OF APPLICANT/E W�V�1 - [1
LQ
Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planf.ing
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SSEP�iA Checklist
Bu?itlnq c h n i c i a
ECIAL CONDITIONS:
^
r,!
–
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
rtJ
TOTAL $
PERMIT NUMBER
Ar - 4- ,
03* *45.00
*4500 t�
*4500
A *0.00 0
45232
06-04-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'06'�4=i8'2 45242 *45.00°
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