1983, 04-12 Permit: 83A-2863 Plumbing FixturesNUMBER 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 AD7JOB ADD ESS
�� _ ��/� LEGAL DESCRIPTION - SEE ATTACHED
1.LOT LO K SUB I ISION PARCEL NUMBER/S
2.
OWNER'^ PHONE
3. :YiAA ilapo.#-
ADD SS/ �„ emnl� ZIP � ^�—,u Actual Set Backs in Feet
'/`' /'KJ�in'C� 7!��! North South East West
CON ATOR r
PHOrjE
Size of Parcel
Zone Classification
4' AD�SS S /
�i/C l�aox",C_
ZIP
Imo/
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
l�
TOTAL $
Plans Examiner
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
THIS BECOMES A PERMIT.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
Baths
No.
Stories
No. Rooms
No. of Dwellings
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF❑ OTHER
LD. PLMB. ❑ MECH. ❑ M.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK O
num.Dist.
ELocation (Area)
FEES COLLECTED
s. u b
b
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
Public ❑Private El
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
performance of construction. SEER VERSE SIDE FOR REQUIRED INSPECTION
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
/*. /V's
PERMIT NUMBER
Fire Marshall
�,e, /G
Mobile Home
Co. Engineer
Other (Specify)
Utilities
rI*
W44.
"h/�
l�
TOTAL $
Plans Examiner
ll`"'��((
l�_
�
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
"Y/ r
THIS BECOMES A PERMIT.
I -y
uilding Technician PERMIT IS NONTRANSFERABLE 0� 41-�;1� 2 —1 i3 2 8 6. 3 z * 4 5 0! 0
00
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL