1983, 11-16 Permit: 83B-1732 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.
2.
STREET ADDR SS
9y0� r Mvbo
LOT BLOCK SU S(
DIVI ION
PARCEL NO.
OWNER �/p
3 ADD 'J
MAIL! ADDRESS
3719 Eric •
4. CON CTLC /J/WM /Ib
AD RESS t71� V/
DESIGNER
5.
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North I South Fast I West
LICEIy$E EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential D
Commercial 0
ZIP
4220
PHONE
Type Const.
Occupancy I' Sp nkiered
DYes DNo LIMN' d.
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin Basement
TYPE c,,'9 NEW ❑ ALT. 0 AD' N. ❑ RPL. ❑ MVE.
7 OF
WORK BLD. e6 PLMB. 0 MECH. 0 M.H. 0 POOL 0 OTHER
NO Bailie
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yesu No❑
Received Yes 0 No0
Number
8.11-
DESCFIBE WORK /) A �• 07J//uuXwQ'�
X c• /
VALUATION S URGE S ELECTRIC
UTILITIES
9.
Shorelines/Flood Hazard
YesC Not Applic.D
Plans Required 0
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC O
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 •r not. The granting of a permit does not presume to give au-
thority to violate or cancel the •rovisions • any o state or local law regulating construction or the performance
of construction. SEE REVE r SIDE F e E • Uf; D INSPECTIONS
SIGNATURE OF
OWNER OR GENT - / � DATE APPLICATION
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Seel. wk.
e1,4
a_ 3-420
1.
ti(-.
Plans
Exam.
Building
Tech.
let weir
-ado
iW Jur
/fit-FQ.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mach
Plan Check
SEPA
Modular/
MFG Home
Other (Specify)
CO
TOTAL $ �✓
PERMIT NUMBER
Fi3B /9'3Z
03* *7300
*73.00.
A *000 3
17312
11-16-83
2 6479.
d
0
r�
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEIS9Uib1 6 - 8 3 PERMITN0. 3' 2.2 '* 7' 3, 0 O.& AL