1984, 04-04 Permit: 84A-2908 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.
ovv
3. (ki
BLOCK
/D /G 75 lail-a"cci zP
SUBDIVISION
PARCEL NO.
v ZALXxF*
PHONE
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
CONTRACTOR
4. c o GO 6Tac. fee/em"'
DESIGNER
5. ADDRESS
ZIP
!CENSE EXPIRES
,elty_
ry v77��
PHONE
Actual Set Backs In Feet to:
North I South {East I West
Zone Classification
Sizeof Parcel
Residential 0
Commercial 0
Type Const.
Occupancy
Spr nklered
Oyes ONo DReq'd.
PHONE
New Const Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Dock
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE tOIEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF 0 WORK 0 BLD. �PLMB. O 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 VesO No0
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILLIITIES
GAS
15... -
Feet: ELECTRIC
Shorelines/Flood Hazard
VesO Not Aeolic. 0
Plans Required 0
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that 1 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 provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE Sp (�pq pEOUIREDD INSPECTIONS
SIGNATURE OF L -JS V l // APPLICATION.,/. G r L
OWNER OR AGENT O [� V�—� 1� DATE 0
SPECIAL APPROVALS SPECIAL CONIiITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
3uJ�.
( `J t 42/C-
G�/rT
'a-#6 4
�
t %/
PERMIT IS NONTRANSFERABLE
)PERM IT 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 $ `U t
PERMIT NUMBER
zqoa
03* *70.00
*70.006
A *0,00 8
29072
04-04-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
~04-.8,'4 290,81 *70.00af-E
DATE I gED PERMIT NO. TOTAL