1983, 07-14 Permit: 83A-6479 Plumbing FixturesPLAN 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
1.
STREET ADDR �rter-pt L '
PARCEL NO.
2.
LQT
BLOCK
SUBDIVISION
SP 75 —
LEGAL DESCRIPTION:
3.
OW_ItReP iNcie
MAENGA,4DREgS IA) pcE
03-'/03
PHONE
4.
5.
CON�iA1/475r5
0.
LICENSE EXPIRES
'5199-07
PHONE
Actual Set Backs In Feet to:
North (South
`East
IWest
Sim of Parcel
Zone Classification
Residential 0
Commercial 0
ADDRESS
DESIGNER
ZIP
Type Const.
Occupancy
Spr nklered
DYes ONo OReq'd.
PHONE
New Cors. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE .e(NEW 0 ALT. 0 AD' N.
7. OF
WORK 0 BLD. flLMB. 0 MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Fln. Rooms
No. Dwellings
Certni. of Exempt.
or Variance
Required YesO No❑
Received Yea❑ No❑
Number
8. r J�9`_
NIL.f
DESCRIBEm / IR@
Shorelines/Flood Hazard
Yes❑ Not Apollo. 0
Plans Requ red 0
Recei ed O
VALUATION
9.
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 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 RE r HIRED INSPECTIONS
SIGNATURE OF
OWNER OR AceENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Flre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
DATE
APPLICATION 3
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
InI G
3 .siKA<
11-113. 5
I NK
k1-1- N TFC.
1 PLAC.
N
PERMIT 15 NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
53,
TOTAL $ 53. 3-
PERMIT NUMBER
03*
A
647.8
07-14-83
6479.
*5300
+153006
*GOO 8
G.
0
0
W
—J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATECISSUEd`4 - 843
•
PERMn'Ma.7' 9 z
*5300tWAL