1982, 05-13 Permit: 82A-3728 Plumbing FixturesPLAN NUMBER
a ..
APPLICATION/PERMIT
SPOKANE COUNTY g3treDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
2.
BLOCK
BDIVISION7/( •
-
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3. OS -V - L� JL41
ADDRESS ,r
j 11. l 1
CONI ACTOR (�
4. k ' 1 / I ��.r�l.
AD ESS _
PHONE
ZIP..
qy<�.
PH9N E
Actual Set Backs in Feet
North 'South FEast 'West
Size of Parcel 1 Zone Classification
Z
Type Const.
Occupancy
Sprinklered
❑Yes ENo ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
AD'N.
PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public El Private ❑
USE CODE
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
to give authority to violate or cancel the provisions of any other state or local la regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT! SJS
DATE OF APPLICATION '4 f %? 4
7 ✓` SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
l 'i
/tip,
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
03* *17.00
* 1 7.00 rn
* 17.006
A *0.00
3727
05-13-82
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'5 -13 8'2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
37 2, 8 z
PERMIT NO.
*17.00°. -
TOTA L
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