1983, 04-25 Permit: 83A-3233 Plumbing FixturesPLAN NUMBER APDL IC'►AT ION / PERMIT
PERMIT NUMBER
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
1. STREET ADDRESSN'• �7Q/— 4.)/j (24-
PARCEL NO.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
I
OWNER
PHONE
PHONE
3. 1.6o mac. N &W-9
MAILING ADDRESS
ZIP
ua t ks in Feet to:
North South East
West
C TRACTOg
�t.�� 11 aa,��.��,�4,
LI C NSE EXPIRES
`,.;23
PHONE
Size of Parcel
Zone Classification
Residential ❑
4. 'eo
S'
�Y'3y��
Commercial ❑
r 1 . 1�;
Aj2DRESS
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5•
ADDRESSZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
-
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
I Fin. Basement
Unfin. Basement
TYPE El NEW ED ALT. El AD'N. 11 RPL. El MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF 1:1 OTHER
WORK 1:1 BLD. ❑ PLMB. ElMECH. 1-1 M.H. ❑ POOL
Certifi.ofExempt. _T
Required
Yes[] No El
Number
or Variance
Received
Yes ❑ No ❑
DESCRIBE WORK
8' �-
Shorelines/ Flood Hazard
Plans Required ❑
Yes Not Applic. ❑
Received ❑
VALUATION I
9
SOOUIICE
GAS
ELECTRIC
PUBLIC ❑
SEPTIWATER I C ❑
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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 provi ' s o ny other state or local law regulating construction or the performance
of construction. SEE REVERSEAl FOR R QUIRE SPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVA
SPECIAL CONDITIONS: (SEE REVERSES[ DE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
Ky �,
SEPA
Planning
Fire
a d
Modular/
MFG. Home
Prevent.
Engineer
Other (Specify)
/�
Utilities
c
en
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech.
IN 180 DAYS
_
u� 4 3
0 o f
G * 8 5' O O 0
.Zr
DATE ISSUED PERMITNU
tl
O
V
W
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