1983, 05-25 Permit: 83A-4471 Plumbing FixturesPLAN NUMBER I AF t'LIUA I IUN/F 'LIMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
1.
LOT I BLOCK
2.
OWNER
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
l 7 c I —03
PARCEL NO.
dJ • �+ � CRJ,� � �
MAILING ADDRESS
CO RACTOR
A o-0 'Sym` AfG/4Jec"t,
ADDRESS
/303 C
5.
ADDRESS
CHANGE OF USE FROM
6.
TO
North
Size of Parcel
Type Const.
ZIP ■ Main Floor
South IEast
West
cone ciasSiTicauonI Residential ❑
Commercial ❑
Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
n Remodeled Valuation Total Bldg. Floor Area
Upper Floors Garage/Storage Greenhouse
I Fin. Basement I Unf in. BaseME
TYPE El ALT. 1:1 RPL. F-1
PHONE
PHONE
No. Fin. Rooms
No. Dwellings
&4EW C1 AD'N. MVE.
7 OF
WORK ElBLD. f�LMB. ElMECH. ElM.H. ElPOOL El OTHER
ZIP
Certifi.ofExempt.
LICENSE EXPIRES
PHON
or Variance
937��3
WORK
FIX—,Yes❑
ZIP
Plans Required El8
gy2/G
TO
North
Size of Parcel
Type Const.
ZIP ■ Main Floor
South IEast
West
cone ciasSiTicauonI Residential ❑
Commercial ❑
Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
n Remodeled Valuation Total Bldg. Floor Area
Upper Floors Garage/Storage Greenhouse
I Fin. Basement I Unf in. BaseME
TYPE El ALT. 1:1 RPL. F-1
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
&4EW C1 AD'N. MVE.
7 OF
WORK ElBLD. f�LMB. ElMECH. ElM.H. ElPOOL El OTHER
_F
Certifi.ofExempt.
Required Yes❑ No❑
Number
or Variance
Received Yes❑ No[ -]DESCRIBE
WORK
FIX—,Yes❑
Shorelines/ Flood Hazard
Plans Required El8
Not Applic. El
Received ❑
VALUATION
SOOUFCE
CIC
GAS
ELECTRIC
PUB IWATC ❑
SEPT G❑
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE 11
I SEWER 11Public
❑ 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 stftfOR RE RED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION ,� o2.S ,�3
OWNER OR AGENT DATE 'g
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
'
PRELIM. FINAL
DATE
, / we—Plan
Check
Env. Health
Aq 64'51wf
of
SEPA
Planning
Modular/
s rdK
MFG.Home
Fire
Prevent.
S K
Other (Specify)
Engineer
OL W
ej`�
Utilities
TOTAL $ 0�7
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATE
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
( 5 _ p z
DATE r 5 ED 5' _ U 3
Building
Tech.
�
PERMIT NUMBER
E'1�4 -401
U
PERMIT NO! z * O O �+AL
Q
O
C-3
W
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LL.