1983, 05-09 Permit: 83A-3801 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 3A
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS C P LEGAL DESCRIPTION — SEE ATTACHED
1.
1 nT I RLOCK I SUBDIVISION PARCEL NUMBER/S
OWNER PHONE
110 S-1 I
3. ADDRESS �` ZIP / Actual Set Backs in Feet
t �1 I I S�%1Z M N `1 Ili? 4 O A b North South East We
C NTRACTOR PHONE Size of Parcel Zone Classification
"17:-3 a3
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
-7 C -Y, q YA ' 1�I
1Z
❑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
I Unfin. Basement
s.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE OK NEW ❑ALT. El AD -N. ❑ RPL. ❑ MVE.
7, OFF-1OTHER
❑ BLD. ElPLMB. ❑ MECH. ❑ M.H. ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
r
8. 6i Ili % i`7 F �ti: � �QjEa>
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
Q, UTILOITIES Public Private 01
I l
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 cos.(;0
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
�:: I q Y :N
Mech.
DATE OF APPLICATION -/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
I
Plan Check
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
e
ec
V1' V 10
r \ �Y
L -1M vvt
f- I) W
(� D5' toOSAc
I 14-wi -T
! Lav )0g#PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ 00,
03* *;5n0
* �0
00;=
6 4 ; q.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
05!09-8-- 380.12
DATE ISSUED PERMIT NO.
*65,00a�-J-
TOTAL