1983, 08-23 Permit: 83A-8037 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
LOT
2.
OWNER
3. 74t414c/9-y4
MAILING ADDRESS
BLOCK
/f( r
SUBDIVISION
PARCEL NO.
PHONE
CO TRACTOR /
4. �`-" SA
f k— re 4/09 t) 4L,
ADDRESS o2 rV�'..e. /—
DESIGNER
5.
LICENSE EXPIRES
PHONE
ZIP
P/a E,3`f�3
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North ISouth
Size of Parcel
East I West
Zone Classification
¶9c /G
Type Const.
Occupancy
Residential E
Commercial E
Sprinklered
GYes DNo LReq 'd.
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE ANEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. KPLMB. ❑ MECH ❑ M.H. LIPOOL
OF
❑ OTHER
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor 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 YesE NoE
Received YesE No❑
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
F
UTILITIES
16 f s—
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC E
SEWER E
Shorelines/Flood Hazard
Yes❑ Not Applic. G
Ownership
Public ❑ Private 0
I hereby certify that I have read and examined this appl cation 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 provision of . • other state or local taw regulating construction or the performance
of construction. SEE REVERSE OR REO IRED INSPECTIONS
SIGNATURE OF APPLICATION 03
OWNER OR AGENT DATE '2.?'8-3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
4t123 -
SPECIAL CON ' ITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received G
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Horne
Other (Specify)
Sa
TOTAL $g
PERMIT NUMBER
8-5A 'g1)--"?
03* *45,00
*45.006
A *0.00
803.62
08-23-83
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE al' 2 5 - 8 3
PERMITNO: 3' 7 z
*45,OO17,01AL