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1983, 05-09 Permit: 83A-3782 Plumbing Fixtures
PLAN NUMBER APPLICATION /PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675 1. 2. APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS 11b03- -o6 E. Av4usha LOT BLOCK SUBDIVISION PARCEL NO. 3. OWNER LUOL AP) PHONE PHONE LEGAL DESCRIPTION: MAILING ADDRESS ZIP Actual Set Backs in Feet to: North South East l West CO RACTOR LICENSE EXPIRES 4. 6© 6-6 514 Jf t cl-(A VIC 44 _tit_ ADDRESS l� c2-o y (4-27 /co r'fess 157,3 Size of Parcel LIZone Classification Residential ❑ Commercial ❑ Type Const. Occupancy Sprinklered EYes ❑No ❑Req'd. DESIGNER 5. ADDRESS PHONE New Const. Valuation Remode ed Valuation Total Bldg. Floor Area ZIP Main Floor Upper Floors Garage /Storage Greenhouse CHANGE OF USE FROM 6. TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. 7. OF ❑ OTHER WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required Yes ❑ No Received Yes❑ No❑ Number DESCRIBE WORK 8. Shorelines /Flood Hazard Yes ❑ Not Applic. ❑ Plans Required ❑ Received ❑ VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC WATER PUBLIC ❑ PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER El Ownership Public ❑ Private ❑ 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 au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVER _ SID yI R REQUIRED INSPECTIONS SIGNATURE OF APPLICATION OWNER OR AGENT DATE APPRO LS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Fr. Heair Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS FEES COLLECTED Building Plumbing 8s Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ G�`�� PERMIT NUMBER E &A 3Z'2 ^3* *85.00 *85.006 A *0.00 8 378.12 05-09 -83 2 6.[t79. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUED 0 9 - 8 3 PERMIT 407 8, 2 2 * 8 5, 0 0 mrtAL