1983, 09-12 Permit: 83A-8947 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
LOT
2.
BLOCK
C 7.01//it rc y
SUBDIVISION
PARCEL NO.
OWNE
3.Ppar yucr,
,MAILING
;RESSb
PPONEE 99/
PHONE
LEGAL DESCRIPTION:
Sera -s
4RACTOR
U E ra�cc.�OD(tESS i? lo X- �:, gb /w4/5
DE((SIIGNER (�
5.
LICENSE E) IgE
PHON
S3 '52)3
Actual Set Backs In Feet to:
North (South
Size of Parcel
PHONE
Type Const.
Occupancy
New Const. Valuation
East
West
I Zone Classification
Residential 0
Commercial O
Spr nklered
ales DNo OReq'd
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
Unlin. Basement
TYPE W --NEW 0 ALT. D AD' N. 0 RPL. 0 MVE.
7. OF (J�
WORK 0 BLD. SW-PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fln. Rooms
No. Dwellings
Certill. of Exempt
or Variance
Required Yes0 No0
Received Yes0 No❑
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
frE Xi r'5
L( 1`
ELECTRIC I WATER
PUBLIC 0
PRIVATE D
Shorelines/Flood Hazard
VasO Not Aeolic. 0
Plans Requ red D
Received 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this applcation 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 wheth sp ified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the ds of any other state or local taw regulating construction or the performance
of construction. SEE REVERS' • •L4 • R R IRD I ;- PECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVmS
PRELIM. FINAL D E
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam
Building
Tech.
APPLICATION g4/FJ, 9
DATE r//// 7T33llJJ
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
U�l
a/-5 Lower" / E-
-s.*
PERMIT IS 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)
TOTAL $
PERMIT NUMBER
BSA e89 Lk -7
03* *61.00
*61,00'6
A *0.00 r3
s.
89462
09-1.2-83
2 6419.
)-
CL
0
W
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n9b:.
DATEQSSUEDI 2 8
PERMIT NO. " 7 Z * 6 10 0 LiAL