1983, 10-11 Permit: 83B-283 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
OWNE
3.
Lek .�
SUBDIVISION
ILINGAD�R
C�2 �5pr !PI th--/-'
TRACTOR
4. A, ut rDi
I
P
PHONE
LICENSE EX ,S,S
•
DESIGNER
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
TO
TYPE ALEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 OF WORK ❑ BLD. %PLMB. ❑ MECH. ❑ M.H. ElPOOL ❑OTHER
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC E
PRIVATE ❑
SEWAGE
SEPTIC E
SEWER E
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North South
Size of Parcel
Type Const.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
East
West
Zone Classification
Residential ❑
Commercial E
Spr nklered
❑Yes ❑No ❑ Req 'd.
Remodeled Valuation
No. Floors
Certifi. of Exempt.
or Variance
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required
Received
Yes No
Yes ❑ No IT
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Ownership
Public O Private E
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 wh- er pecified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel t . o ions of an others to or local law regulating construction or the performance
of construction. SEE REVE • L FO 0 RED SPECTIONS
SIGNATURF OF
OWNER OR AGENT
SPECIAL APPR
PRE_IM. FI
Env. Health
A S
DATE
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
/CIA. /ge.4.
,/ 5,dc
/ --Z-69
PERMIT IS NONTRANSFERRBLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required E
Received E
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
(10
Other (Specify)
TOTAL $
PERMIT NUMBER
02.)
03* *45.00
*45,006
H *0.00 8
282-2
10-11-83
2. 6.479.
d
0
W
-J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-11- ) 28,35
PERMIT NO.
DATE ISSUED
*45.00
O J
40TAL