1983, 06-06 Permit:83A-4843 Plumbing FixturesPLAN NUMBER
APPLICATION—
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
STREETADDRESS PARCEL NO.
1 • fir? 0 LL �1-
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNE '
�A ® 4 09 0
PHONE PHONE
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East
West
CONTRACTOR
LICENSE EXPIRES
PHO
Size of Parcel
Zone Classification
Residential❑
P ��/� /�/
6 3
Commercial ❑
4.
ADDRESSn,
ZIP
Type Const.
Occupancy
Sprinklered
�r ey
/v .7 7
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover DeckUncv.
Deck
Fin. Basement
Unfin. Basement
6.
TOF YPE NEW 11 ALT. ❑ AD'N. 11 RPL. El MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
%. ❑ OTHER
WORK El BLD. 11 PLMB. El MECH. ❑ M.H. F-1 POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORKf
8•
Shorelines/Flood Hazard
Plans Required ❑
! - �� _
Yes❑ Not Applic. ❑
Received ❑
VALUATION
I SOOF
GAS
ELECTRIC
WATER
PUB IC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF �/) APPLICATION /P ? ^ �j7�
OWNER OR AGENT J�L�%�f_il E DATE f� 7 o
Mach.
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
Planning
Utilities
SEPA
Plans
Exam.
104
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
2- ,- ?0 4-S ) — �v 14-
2-
42- SUS j— K-;5
j — Tull I - pW
5- 146velu
f_ '7�0 PIPS 11 y
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMITNUMBER 2
— `I—O J
03* *49.00
*49.0010
A *000 0
48422
06-06-83
2 6,479.
TOTAL $ Dv
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISStt1ED~ O `" :>�' 8a �' PERMIT NO.� 4.' 3 z * 4 9. 0,4 (9rkL
0
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W
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