1983, 08-05 Permit: 83A-7420 Plumbing FixturesPLAN NUMBER APPL ICAT ION /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 PARCEL NO.
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
3.
�V+ 1✓UX
RACTOR
4. ct1�+r
5. ADDRESS
PHONE
ZIPActual Set Backs in Feet to:
417 North South East West
PHONE Size of Parcel Zone Classification Residential
S t —J3 % Commercial ❑
ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
PHONE New Const. Valuation Remodeled Valuation I Total Bldg. Floor Area
ZIP I Main Floor I Upper Floors I Garage/ Storage I Greenhouse
CHANGE OF USE FROM I TO I Cover Deck Uncv. Deck I Fin. Basement Unfin. Basement
6.
TYPE
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
XNEW El ALT. ❑ AD'N. ❑RPL. 1:1 MVE.
%. WORK ❑ BLD. XPLMB. ❑ MECH. ElM.H. ❑ POOL ❑OTHER
OF
-
Certifi.ofExempt.
Required Yes❑ No❑
Number
or Variance
Received Yes❑ No❑
DESCRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required ❑
— / X re� L5
Yes❑ Not Applic. ❑
Received ❑
VALUATION I
9•
SOOUFCE
GAS
ELECTRIC
PUBLIC ATER❑
SEPT AGE❑
Ownership
FEES COLLECTED
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 pr sions of any other state or local law regulating construction or the performance
of construction. SEE REV RS I E FO O RE INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
�—
OWNER OR AGENT DATE
Mach.
SPECIAL APPRO A S
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINALJ DATE
�.� /✓` r%
/
Plan Check
Env. Health
SEPA
Planning
Fire � I
Prevent.
Engineer
Utilities
/1Ci, f����r✓
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building _ IN 180 DAYS
Modular/
MFG.Home
Other (Specify)
TOTAL $
PERMIT NUMBER
n
-
1i
:-7 ,.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B8ECOMES A PERMIT.
0-5
DATE SSUEDO — J
PERMIT P` 0 5
* 21, 0 0 W01 -JAL
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