1984, 03-01 Permit: 84A-1746 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
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
STREETADDRESS PARCEL NO.
1 aT- 1763 )to27-A_,
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2. I
I
OWNPHONE
Sint/
PHONE
t_ TK
3. L4 _
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East West
CsyJTRAO�
L NSE �XPI�iES
PFjQ_NE
Size of Parcel
Zone Classification
TCom�meercial❑❑
�CT
4.
A REQS^A -�
caRL.c-a a& /—
ZI���`�7�
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
P0--
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW El ALT.
. ❑ AD'N. ❑RPL. ❑ MVE.
!. OF El OTHER
WORK ❑ BLD. < PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required Yes❑ No El
Number
or Variance
Received Yes❑ No❑
DESCRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required ❑
Yes Not Applic.❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
WATER
PUBLIC ❑
SEPT CG❑
I
Ownership
FEES COLLECTED
9•
I UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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
Building
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 i2rovisiguna4gany other state or local law regulating construction or the performance
of construction. SEE REVW(9_WSIQ9FOR R OUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
�� S/
OWNER OR AGENT DATE
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health .;
3 't., C
3, 46 01S
SEPA
Planning
F
/ f1V4f_
f
Modular/
If
MFFG.G.Home
>„
Fre
4 !f
Q.
Prevent.
v
Engineer
G G
Other (Specify)
Utilities
U_
TOTAL
SEPA
WHEN MACHINE VALIDATED IN
THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
P.;�j
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech.
IN 180 DAYS
_
DATEWSS EDO 1 ) 'P PERMIT11�
t
(J. 4.6 5 R. 0, A fOf-AL