1983, 10-31 Permit: 83B-1097 Plumbing FixturesMain Floor
Zone Classification
PLAN NUMBER
STREET ADDRESS
1.
LOT
2.
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
".-79„2/ Com,kbAJ
BLOCK SUBDIVISION
PARCEL NO.
LEGAL DESCRIPTION:
3. OWNEDRE� IP�51
IL/ �, V' 5 �laS t e
CO°,�T�ACTOR JJ LICENSE/71p
4. /� • �' L t- C i y
D SS / .J
DESIGNER
5 ADDRESS
PHONE
ZIP
PH41JE
ZIP
CHANGE OF USE FROM
TO
PHONE
ZIP
TYPE 1yIGEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
WORK ❑ BLD. ,$ LMB. ❑ MECH. ❑ M.H. ❑ POOL
7. OF ❑ OTHER
DESCRIBE WORK
8.
/t
Actual Set Backs in Feet to:
North 'South
Size of Parcel
Type Const. I Occupancy
New Const. Valuation
East
West
Residential ❑
Commercial ❑
Sprinklered
❑Yes 0 N ❑Req'd.
Remodeled Valuation
Upper Floors
Cover Deck
No. Baths
Total Bldg. Floor Area
Garage/Storage
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE
9' OF
UTILITIES PUBLIC 0
PRIVATE ❑ SEISEWER ❑
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 compiled with wh- her specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel e ons of any other state or local law regulating construction or the performance
of construction. SEE REV S . I FO RED SPECTIONS
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes No
Received Yes ❑ Noll
Shorelines/Flood Hazard
Yes Li NotApplic. ❑
Ownership
Public ❑ Private ❑
p
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPR
PRELIM. FI
VA S
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
Y;(
�.l APPLICATION /64_15./
DATE
SPECIAL COND TIONS: (SEE REVERSE SIDE FOR NOTICE)
/ —$47– / Al% 1/"4d.:L-
-/ /—)7 '(P
/- 5/..
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
415 f:e5e2
Other (Specify)
TOTAL
PERMIT NUMBER
t .?,7155. 1,07
03* *4500
*45006
*0.00 8
109.6g
10-31-83
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED •-•8i " PERMIT NO. 9' z * 4 5, u O TOTAL