1984, 04-25 Permit: 84A-3790 Plumbing FixturesPLAN NUMBER APPLICATION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
APPROVALS
LOT
BLOCK
2.
PRELIM.
I
DATE
0ER
3.
"
MAILING ADDRESS
CONTRACT
4.
IV�Ci eJ� (— Ltil�Tt4 �� �T� 4✓
Planning
ADDRESS_
2,2
DESIGNER
5.
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
CHANGE OF USE FROM
6.
TO
PHONE
LICENSE EXPIRES
E
7 F_W <1 North South East West
PHONE Size of Parcel Zone Classification Resiidmntial0
_324-S6 0
ZIP Type Const. Occupancy Sprinklered
Dyes ONO ❑Req'd
PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
ZIP Main Floor Upper Floors Garage/Storage Greenhouse
Nor. No. Floors No. Fin. Rooms No. Dwellings
TYPE NEW ❑ALT. ❑ AD'N. C1 RPL. ❑ MVE.
!• OF �,,/ ❑ OTHER
WORK 11 BLD. ,l�.PLMB. ❑ MECH. ❑ M.H. El POOL Certifi.ofExempt. Required Yes❑ NOD Number
or Variance Received Yes❑ NOD
DESCRIBE WORK Shorelines/Flood Hazard Plans Required ❑
8• Yes❑ Not Applic. ❑ Received ❑
VALUATION I SOOURCE GAS ELECTRIC WATER I PUBLIC ❑ SEPTIC ❑ Ownership FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 an Cher state or local law regulating construction or the performance
of construction. SEE RZVEME SIDE FOR QUI ED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
/,/— 76_�
Env. Health
IV�Ci eJ� (— Ltil�Tt4 �� �T� 4✓
Planning
/ — 7Z� b
02
Fire
Prevent.
Engineer
— l�t S�iu/J4S �✓
Utilities
SEPA
PERMIT IS NONTRANSFERABLE
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
-
180 DAYS
BuildingIN
Tech.7�K
Building
1�
Plumbing
V< cc,
Mech.
Plan Check
SEPA
Modular/
MFG.Home
NOW
Other (Specify) L—
TOTAL $
PERMIT NUMBER
(b - 371 o
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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DATE�41.11 � / PERMITIIO. Q• 0 z
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