1983, 11-17 Permit: 83B-1807 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTIVIEW 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.
8 /3 S, ��4<
LOT
2.
BLOCK
SUBDIVISION
OVyllER
3 r Of 4 (-4`/4
MAILING ADDRESS
PHONE
CoUN TRACTOR _
4. 4ocp 5f4( 44se.rl4''c1(,44C
ADDRESS
/3„2a3 £ -5 —
LIC NSE EXPIRES
PHONE
ZIP
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 1South {East I West
Size of Parcel 1 Zone Classification
ZZII Pj /
/7 ��o
Type Const.
Occupancy
Residential Ti
Commercial D
Spr nklered
❑Yes ❑No f7Req•d.
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE VIEW ❑ ALT. ❑ AD' N. ❑ RPL. El MVE.
7. OF ❑ BLD. -PLMB. ❑ MECH. [7 M.H. ❑ POOL
WORK
❑ OTHER
New Const. Valuation
Remodeled Valuation
Total Bldg. t-toor Area
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi, of Exempt.
or Variance
Required Yea❑ Nof7
Received YesC Noll
Number
8.
DESCRIBE WORK
/G o/j-7
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
Shorelines/ Flood Hazard Plans Required C
Yee❑ Not Appllc. 1 I Received C
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public CI 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 REVERS SIDREQUIRED INSPECTIONS
SIGNATURE OF APPLICATION-�
OWNER OR AGENT / DATE // — 'f —`p-
"
SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health4
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 r
Plumbing i/J „
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMITNUMBER
8U lf!7'
''7* *45.00
*45006
A *0.00
18062
11-17-83
< 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IJSLED 1 7 - 8 3
PERMIT HIS. 0.r 5
*45.001v°{y,L