1983, 01-06 Permit App 83A-0095 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
LEGAL DESCRIPTION —SEE ATTACHED
2. 1 1
O NER �1 JJ
3. ee /��/SGiLJ
ADDRESS
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CONTRACTOR ll//
4.
.�' ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM TO
s.
P
ZIP
pe
❑Yes ONO ❑ Req'd.
TYPENEW ❑ALT. ® O'N. ❑ RPL. El MVE. No. Baths No. Stories No. Rooms No. of Dwellings
❑
%, OF El OTHER
WORK � BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 13 POOL CERTIFICATE Req'tl. I Rec•tl. Not Req'tl.
of EXEMPTION
s
DESC WOR Enum. Dist, Location (Area) FEES COLLECTED
/ PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
fV�
TOTAL $ G�
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
0,7 0 6 8)
nATF ISRIlIFn
PERMINUMBER
03* *21.00
*21.00
A *0.00
9.42
-01-06-83
2 6479, -
95z
PPRMIT Nn
f 2 10 0 (L –
TnTAI
VALUATION
SOU
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
PC
OF
UTILITIES
Public ❑Private ❑
Single
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
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
`)
DATE OF APPLICATION— SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
mmmmummmolm—
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
Lcb+—
SEPA
Planning
Mobile Home
Other (Specif
Fire Marshall
Co. Engineer
/ PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
fV�
TOTAL $ G�
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
0,7 0 6 8)
nATF ISRIlIFn
PERMINUMBER
03* *21.00
*21.00
A *0.00
9.42
-01-06-83
2 6479, -
95z
PPRMIT Nn
f 2 10 0 (L –
TnTAI
Lo-( '721
AWr-