1983, 03-21 Permit: 83A-2069 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. E. 13112_
LOT
2.
c ATALDO
PARCEL NO.
BLOCK
SUBDIVISION
3.
OWNER
SCOTT WILSOrJ
PHONE
9z4-040?
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
13/02, C/}"TAI..AO
ZIP
q97/
Actual Set Backs in Feet to:
North 'South
4.
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
LIZone Classification
East
West
Residential 0
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Spr nklered
DYes DNo °Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE O'NEW 0 ALT. 0 AD' N.
7. OF
WORK 0 BLD. 13.5LMB. 0 MECH.
W
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Reams
No. Dwellings
Certiti. of Exempt.
or Variance
Required Yes° No0
Received Yes° No0
Number
DESCRIBE WORK
6 • PLA rn ft' PEam 1—r 3 FI x-nA r2eS
SOURCE
OF
UTILITIES
VALUATION
9.
GAS
ELECTRIC
Shorelines/Flood Hazard
Yes° Not Appllc. 0
Plans Requ red 0
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 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 provisions of any other state or local law regulating construction or the performance
of construction. SEE RE 51 y FO REO IRED/�1 SPECTIONS
SIGNATURE OF
OWNER OR G `% AraiENT / ' DATECATION
SPECIAL APPROV
PRELIM. FINAL
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
I sink -
I We
I 'Tub
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Od
Plumbing /2
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Lcs
O he "—Ckyr
Other Specify)
TOTAL $
PERMIT NUMBER
834— 2069
03*
A
20682
03'-21-83
2 6479.
* 1700
* 17.00 175
* 17.00
*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE9SSt1E132 1' — 84 3
•
[4
PUMASC 9 5
*17,0.01°OtAL