1983, 07-22 Permit: 83A-6833 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 8111 3EFFERSON /SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
cam/ 102g/Cyr94,0O
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 2 rcr.a
MAILING ADDRESS
Coo sr,
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North ISouth [East I west
CONTRACTOR
Q. Gocj Soc. uftraaG.c, -%uG
ADDRESS
/3203 e -
LIC NSE EXPIRES
a7 Y
PONE
y?•13Y�3
Slze of Parcel 1 Zone Classification
Residential 0
Commercial 0
ZIP
719.2i6
Type Cant.
Occupancy
Spr'nklered
OYes 0 N OReq'd.
5.
DESIGNER
PHONE
New Cont. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
8.
TYPE ggiEW
7. OF
WORK 0 BLD.
8.
9.
DESCRIBE WOR
VALUATION
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
❑ ALT. O AD' N. ❑ RPL.
Sy PLMB. 0 MECH. 0 M.H.
SOURCE
F
UTILITIES
O MVE.
❑ POOL
/0 ,c1 -rocc5
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
0 OTHER
SEWAGE
SEPTIC 0
SEWER O
NO. Bathe
No. Floors
No. Fin. Rooms
No. Dwellings
Gerbil. of Exempt.
or Variance
Shorelines/Flood Hazard
Yea❑ Not Apollc.0
Ownership
Public 0 Private 0
Required YesO No0
Received YesO No0
I hereby certify that 1 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 the provisio.: any other state or local law regulating construction or the performance
of construction. SEE REVERSE ID - OR R : OUIRED INSPECTIONS
SIGNATURE OF 1 ' APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
9i
722
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
a we
78.vsrt,
«•°3
/c54.ocr4c
(&4X41
(F.
i SrvCC
PERMIT 15 NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Ran Required 0
Received 0
FEES COLLECTED
Building
y�4
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
5314 -Coe33
03* *45.00
*45006
A *000 3
6832
07-22-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE I4UEII'2'2' 8 '3'
(,+p �•. "
Z * 5• o
PERMIT F7O.o TOTAL