HomeMy WebLinkAbout1983, 09-08 Permit: 83A-8779 Plumbing FixturesPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. / /-- ,1Z3 E- , C S ?q Ca
PARCEL NO.
LOT
2.
BLOCK SUBDIVISION
OWNER
3 G1J0 F:✓ 4 £z
MAILING ADDRESS
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North 'South
East I West
CO TRACTOR
4. (3, c-e tc. edrdr.- .a4C_"-)e.--
A4. 2-03 L: FOB .Ae75-
LICENSE EXPIRES
p` �3 —g Y
Size of Parcel
Zone Classification
Residential C
Commercial ❑
ZIP
9. 7b
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
CHANGE OF USE FROM 1 T
Cover Deck
TYPE <NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
% WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. El OTHER
/1°
No. Baths
Upper Floors
Uncv. Deck
No. Floors
Garage /Storage
Greenhouse
Fin. Basement
Unfin. Basement
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 ❑
Ownership
Public ❑ Private C
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 REVERSE SI! F yl<;. QUIRED INSPECTIONS
SIGNATURE OF agimrPAPPLICATIONS OWNER OR AGENT A DATE '-e5"4
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
(J
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
5(4"(4"
v2
74'1
v2 w k
��&
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
g5"`
PERMIT NUMB
03* *8500
*85006-
A *000
877.82
09 -08 -83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09 =08 -83
DATE ISSUED
PERMIT NO. 7.9 z
*85,00
O J
TOTAL