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1983, 05-05 Permit: 83A-3689 Plumbing Fixtures
PLAN 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 3 1. LOT BLOCK SU(BD1ION • P-4)< 0# • 2. 3. 7/11 rfri CO go 4 MAIL NG ADDR SS sC, 1419 5 / k RACTOR / 4. (�/S+ffifi t- l i I y hC Sae7/Ur� PHONE 9ati-�'saa PHONE PARCEL NO. LEGAL DESCRIPTION: Zlp) _ O4 Actual Set Backs In Feel to: Norlh (South 5. DESIGNER LICENSE EXPIRES 3 PHONE Size of Parcel Type Const. Occupancy New Const. Valuation liZone Classification East West Residential 0 Commercial 0 Spr nklered OYes ENo 0Reg 'd. Remodeled Valuation Total Bldg Floor Area ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM 6. TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement TYPE ,NEW LI ALT. 0 AD' 7. OF WORK BLD. LMB. 0 MEC N. 0 RPL. 0 MVE. H. 0 M.H. O POOL 0 OTHER No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifl. of Exempt. or Variance Required Yes No❑ Received YesO No0 Number 8. DESCRIBE WORK VALUATION 9. SOURCE OF UTILITIES GAS ,A lLtyc'S ELECTRIC WATER SEWAGE PUBLIC 0 SEPTIC 0 PRIVATEO SEWERO Shorelines/Flood Hazard Yes❑ Not Apollc.0 Plans Required 0 Received 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 the prov �. • $ • any other state or local law regulating construction or the performance of construction. SEE REVERSE INSPFJtfTIONS SIGNATURE OF OWNER OR AGENT SPECIAL APPROVA PRELIM. FINAL DA Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. ,cc- k /t APPLICATION DATE SPECIAL ONDITIONS: (SEE REVERSE SIDE FOR NOTICE) U 3—Aaf's-' r 1-/»/©orO'a-%N ' " -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 $ 6.1473 PERMIT NUMBER 13A 3699 03* *6100 *61.006 A *000 8 36882 05-05-83 2 6479. )1- 0- -J J WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATEQSSUEGt pt g PERMIT/40, "' z * 6100 rem AL