1983, 08-17 Permit: 83A-7900 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
STREET ADDRESS
1.
LOT
2.
owN,-
3 /u,4ft-r LNe>
..WAILINGA D ESS
l aq'l 51,1a -awe
TRACTOR . n ))
4. .VCv Cit1j'r Or /Au
/61/ iicrt7
PARCEL NO.
BLOCK I SUBDIVISION
DESIGNER (2gC)/
5.
ADDRESS
PONE p9/
PHONE
LEGAL DESCRIPTION:
ZIP
a/,
Actual Set Backs in Feet to•
North I South [East I West
LICENSE VPIRES
PHONE
)5734/1527—.S7
ZIP9_Z'
Size of Parcel 1 Zone Classification
Residential D
Commerclal 0
Type Const.
Occupancy
Spr nklered
Chem DNo OReq'd.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Man Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE NEW .0 ALT. 0 AD' N. 0 RPL. ❑ MVE.
%• OF
WOPet 0 BLD. ,o( PLMB. 0 MECH. 0 M.H. 0 POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesD No❑
Received YesD NOD
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
/D
^ 1
ELECTRIC 1 WA
TCR
PUBLIC 0
PRIVATE ❑
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Hazard
Yes Not Apollo. 0
Ownership
Public 0 Private 0
1 hereby certify that 1 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 w111 be complied with whether specified herein or not. The granting of 8 permit does not presume t0 give au-
thority to violate or cancel the v s s of any other state or local law regulating construction or the performance
of construction. SEE REVER SI F R REOUIp�INSPECTIONS
SIGNATURE OF l_ / APPLICATION
OWNER OR AGENT Jlw w DATE S
SPECIAL APPROV
PRELIM. FINAL \OA
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
RI CI
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
/-i /-ze.2/
a p/a,,- .:/
a—�
PERMIT IS NONTRANSFERABLE '
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Req Ired 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ ` v
PERMIT NUMBER
63A 7100
03* *4500
*45008
A *000
789.92
08-17-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEIS5UEDL'
PERMITNO. u Z * 4 5.0 0
ILORAL