1983, 06-29 Permit: 83A-5993 PipingPLAN 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 /_
1. 3 V /
LOT
2.
BLOCK
Iveyte
PARCEL NO.
SUBDIVISION
3 CER
NER
MAILING ADDRESS
4. QD(J RACT� - _ Ji
ADDRESS •
iL/ 47 -AW £xr%
PHONE
LICENSE EXPIRES
PHONE
ZIP
PHONE
'4Z1 5-5o
LEGAL DESCRIPTION:
Actual Set Backs in Feet to•
North ISouth East I West
Size of Parcel 1 Zone Classification
Residential O
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
DYes ONo 0Reg 'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/ Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cow Deck
Uncv. Deck
Fin. Basement
Unfin Basement
TYPE &NEW ❑ ALT. ❑ AD' N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. O MECH. 0 M.H. 4R -POOL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Ceti ill. of Exempt.
or Variance
Required Yes E No0
Received Yes0 No0
Number
8. DESCR(B�xWORK
VALUANON I�
9. 'I
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 provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
9•_ . /l R
OU CE
UTILITIES
GAS
ELECTRIC 1 WATER
PUBLIC O
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Haza d
Yes Not Apolic.0
Ownership
Public 0 Private 0
SIGNATURE OF
OWNER OR AGEN
APPLICATION l� ,--
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
v29
SPECIAL CONDITIONS: (SEE REVERSE IDE_ FOR NOTICE)
�7Saoo)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech
Plan Check
SEPA
Modular/
MFG Horne
Other (Specify)
TOTAL $
PERMIT
04* *19.00
* 1 9.006
A *0.00
599.28
06-29-83
2 6479.
CD
CD0
W
J
IA-
WHEN
L
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'6 x-2,9 78.3
DATE ISSUED
5'99.31 *19.00
PERMIT NO. TOTAL