1983, 08-19 Permit: 83A-7967 Plumbing FixturesPLAN NUMBER
( 3
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.
BLOCK
AI 4/ i o kiA.rcj�
SUBDIVISION
PARCEL NO.
o
3. ate
e t�
MAILIN DRESS
las';q 5? LLQ
TRACTOR
4. VI � YY ant, t ),,,„ ,-L3
PoDR
e DK l g�7
PHONE
/�Si—/99/
PHONE
LEGAL DESCRIPTION:
LICENSE Ex ES
CO /7f y
PHONE
Actual Set Backs in Feet to.
Nath 1 South [East I West
Size of Parcel 1 Zone Classification
Residential ❑
Commercial 0
Type Const.
Occupancy
Spr nklered
0Yes ❑No ❑Req'd.
5.
DESIGNER
PHONE
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 ;KNEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
%• OF ❑ BLD. Oi.PLMB. 0 MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No Dwellings
Certif1. of Exempt.
or Variance
Required VesO No
Received Yes❑ No❑
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
F
UTILITIES
!a rr kt--e-'
GAS
ELECTRIC
Shorelines/Flood Hazard
Yes D Not Applic. 0
Plans Req fired 0
Received 0
WATER
PUBLIC 0
PRIVATE ❑
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 pro Isions of any other state or local law regulating construction or the performance
of construction. SEE REVE' DE FOR UIRE o INSPECTIONS
SIGNATURE OF A� APPLICATION pp��//q/'42'
OWNER OR AGENT ? t.0 DATE 15 / 7155
SPECIAL APPROQ • S
PRELIM. FIN DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
r24 L /i
r%4)
/-5/Sc
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
ES int 7`i(o1
03* *4500
*45006
A *0.00 0
79662
08-19-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ft, nit, s
DATE *Abet)]. 9 — 0+' 3t
'770o((7 d
PERMITNd. U Z
*45.00mtAL