1983, 09-22 Permit: 83A-9362 Plumbing FixturesPLAN NUMBER
APPLICATION
/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 056-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
a23 a3 'N€7ZA
LOT
2.
BLOCK
SUBDIVISION
C r4.461d.)
PARCEL NO.
ow
3. c9 rcjccux.o,
MAILING ADDRESS
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North ISouth
4.
CO} RACTOR
(aocw scams NEGO ' Jwc-
LICENSE EXPIRES
41-1 - y
�
Pp
o7ONE`iett J
Size of Parcel
11 Zone Classification
East
Weal
Residential 0
Commercial 0
/DRESS
3ao3 E- T xts 54—
Zara<
Type Const.
Occupancy
Spr nkierod
DYes ONo CReq'd.
5.
DESIGNER
PHONE New Const. Valuation
Remodeled Valuation
Tot I Bldg. For 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 (4 -NEW
7. OF
WORK 0 BLD.
ID ALT. 0 AD' N. 0 RPL. 0 MVE.
I®,PLMB. O MECH. 0 M.H. 0 POOL
0 OTHER
NO. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif 1. of Exempt.
or Variance
Required Yes0 No0
Received Yes° No0
Number
8.
9.
DESCRIBE WORK
VALUATION
/ D Fi,c
Shorelines/Flood Haze d
Yes0 Not Applic. 0
Plans Required 0
Received 0
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this appl cation 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 provi Eons of any other state or local law regulating construction or the performance
of construction. SEE REVERS r E FO REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
APPLICATION 94_/3
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL ONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
`Gut_
ySrv5
1 10
34n'. -rt
Cc.
/..” sGv.
15rtiC-
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building '/
Plumbing 7&
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
y5tC
PERMIT NUMBER
b3A 3•C.0
03* *4500
*45006
A *000
9361A
09-22-83
A 6479.
0
d
O
V
W
J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
PERMIT 7O. I6 Z Z * 4 5, O OTO AL