1983, 07-27 Permit: 83A-7043 Plumbing FixturesPLAN NUMBER
l/
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
E, /4,7 /4/. /71c -nos/
LOT
2.
01/1/7.R-
t."
WE —
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3 MAILINGA DRESS
9ga, S';/./7, v5es-77
ACTOR
DDRESS
•O,' Ioox 3g.c/
DESIGNER
BLOCK
SUBDIVISION
PARCEL NO.
LEGAL DESCRIPTION:
5.
taPHONE
el79/
PHONE
zuMwe
Actual Set Backs in Feet to -
North I South l East I West
LICENSE EXP E$
PH9fIE ,� 5/
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
PHONE
Type Const
Occupancy
New Const. Valuation
Spr nklered
❑Yes DNo Reg Id.
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
Untie. Basement
TYPE ,NEW 0 ALT. 0 AD' N. ,❑ RPL. 0 MVE.
7. OF WORK 0 BLD. XPLMB. 0 MECH. ❑ M.H. 0 POOL OTHER
NO. Baths
No. Floors
No. Fin. Rooms
No Dwellings
Certif1. of Exempt
or Variance
Required Yes❑ No❑
Received Ves° No El
Number
8.
DESCRIBE WORK
Shorelines/Flood Hazard
YesD Not Applic. 0
Plans Required D
Received 0
VALUATION
9.
SOURCE
F
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 appl cation 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 • •ns of any other state or local law regulating construction or the performance
of construction. SEE REVE • • FOR R ".w' ED 1 LL PECTIONS
SIGNATURE OF .�' - I APPLICATION 17/4/g5
OWNER OR AGENT - a DATE
SPECIAL APPRO • L
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
747
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
/ - 6Lotoct"
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
P73&-704 7
03* *41.00
*41.006
A *0.00
704221
07-27-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEMS$UEI�:, - 8 3
43Z
PERMIT71.{1N.
* 410.0 4AL