1982, 01-27 Permit M82A-652 Plumbing Fixtures11-1__AN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT N MBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
2-~ r`'1 A
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3.
OWNS
ADDRESS
• 1 2 rig
CONTRA TOR
4fr
' ADDRESS
5.
6.
PL �ONE
722_Z�2
ZIP
PHONE
Actual Set Backs in Feet
North 'South 1East (West
Size of Parcel I Zone Classification
DESIGNER
ADDRESS
ZIP
Type Const.
PHONE
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors I Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW ❑ ALT. ❑ AD'N.
0 BLD. LJ PLMB. ❑ MECH.
DESCRIBE WORK
VALUATION
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Enum. Dist. I Location
(Area)
9 Ownership
Public 0 Private 0
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 law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /1— C .r2 SIGNATURE OF APPLICANT�G
'SOURCE GAS
OF
UTILITIES
SPECIAL APPROVALS
NAME DATE
ELECTRIC
WATER
SEWER
USE CODE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
we
I
C L,1/4ki
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
03* *21,00
* 21,00
* 21.006
A *0.00
6 5, 1 g
01-27-82
s 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buildin ec nician 4
PERMIT IS NONTRANSFERABLE 0 1- 2 7 - 8 2 6 5 2 0.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSLJFn
PPR5AIT Hill
*21,000.