1983, 10-12 Permit: 83B-337 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTaVIENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.YZE9I/' s, &"ieV
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
MAILING ADDRESS
k 424/
rE _7646
COr../51.-O
ADDRESS
/M. 0 7
LICENSE EXPIRES
�
i 2 --/
DESIGNER
5.
ADDRESS
PHONE
ZIP
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South East I West
Size of Parcel
Zone Classification
Residential C1
Commercial
PHONE
Type Const.
Occupancy
New Const. Valuation
Sprinklered
Yes No ❑ Reg 'd.
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
Unfln. Basement
TYPE ANEW ALT. ❑ AD'N. ❑ RPL. CI MVE.
7• OF
WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ Non
Number
8.
9.
DESCRIW
ti
VALUATION
Shorelines/Flood Hazard Plans Required I.7
Yes NotApplic. C Received ❑
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC CI
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
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 specifie. ger ting of a permit does not presume to give au-
thority to violate or cancel the provision other stair local I• w regulating construction or the performance
of construction. SEE REVERS • SI
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE
/ 3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Ern. Health
Panning
r
Prevent.
Engineer
Utilities
SEPA
Hans
Exam.
Building
Tech.
/ Sh.- 'e
l - %p i to 1
2- Lzrs
washe
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
.21.'00
her (Specify) 5-.00
tt
TOTAL $ ` 'tie
PERMIT NUMBER
03* *29.00
*29,006
A *0.00
3362
10-12-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 3 ,3 7 z * 9. 0 a
IN180DAYS 1 0 -12 • -8 3 r
GATE ISSUED PERMIT NO. TOTAL