1983, 11-16 Permit: 83B-1786 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.
BLOCK
SUBDIVISION
OWNER/
3. /LL
MAILING AD
S
C011 RACTOR )
4. / 10"r /�
pTRESS 4
DESIGNER
5.
ADDRESS
PHC;NE
k/./,7g/ /9yi
LICENSE EAPI, y
CHANGE OF USE FROM
PHONE
PHONE
ZIP
TO
TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 0 POOL
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South (East I West
Size of Parcel
Type Const.
wir Const. Valuation
Main Floor
Cover Deck
No. Baths
Zone Classification
Residential ❑
Commercial ❑
Spr'nklered
❑Yes 0 N ❑ Req 'd.
Remode ed Valuation
Total Bldg. Floor Area
Garage/Storage
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ No❑
Received Yes❑ Norl
Shorelines/Flood Hazard
Yes NotApplic. ❑
Ownership
Public 0 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 w -cher specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel e pro &ions of any other state or local law regulating construction or the performance
of construction. SEE REV RS D FOR R IR D II1<SPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVAL
PRELIM. FINAL "DATE
nv. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
yv� %Q_Va
DATE APPLICATION hl /
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
/ — AIL&r lf 7c'
1 ' f"---/ae,
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
E:38 /1F't,
03*
*45.00
*4500
*000 E
72 5
11-16-83
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'ISSUED' 8 3
PERMIT Z8.6 z * 4 5.0 0 Ir*TAL