1983, 08-11 Permit: 83A-7617 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
AlUBDIVISIDN 6
-}L2k/,47
PARCEL NO.
owl
3 re -r'
MAILINCaAE DRESS
CRACTOR
4. Ni L' e Y' t -t! tf 4/u.1afi1%5
D SS
°tf x ..{'e//
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North 'South ( East I West
LICENSE EXPIRE
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled 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
Unfin. Basement
TYPE XNEW ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF
WORK ❑ BLD. $,LMB. ❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
8.
DESCRIBE WORK
/i 1 xlLur� 5
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
Public ❑ Private 0
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 th . vi ons of any other state or local law regulating construction or the performance
of construction. SEE REVE I FOR IRED/INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVA S
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
*kkPli
APPLICATION
LtiLLC��� DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
til
ajz1-1-/-L
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
S3A 749 1-7
03* *4500
*/x5,00
*c.00 0'
761.6,P,
00— 1 1 —83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEfSSUED1 1 • - 8 3 PERMIT744. 1. 7 z * 4 5, 0 0 2iD1`AL