1983, 08-24 Permit: 83A-8130 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.
9702
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
OVNER
3
J 2CY 1-O&
MAILIN DDRE S
rC TRACTOR
4. . e_er (2 ILIA.
1ADDRE$6I 82 ,
DESIGNER �wJ��,(
5.
ADDRESS
PX71fr/Y7/
LI o3PIRES
PHONE
ZIPCy
PHONE
ZIP
Actual Set Backs in Feet to:
North 'South {East I West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Residential ❑
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'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 Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ;KNEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. XPLMB. ❑ MECH. ❑ M.H. ED POOL
LI OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No❑
Received Yes Non
Number
DESCRIBE WORK
8.
VALUATION
9.
/22 X-ut-�
SRCE GAS ELECTRIC
UTI LLIITI ES
Shorelines/Flood Hazard
Yes NotApplic. ❑
Plans Required 0
Received ❑
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 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 or not. The granting of a permit does not presume to give au-
thority to violate or cancel th r. isions of any other state or local law regulating construction or the performance
of construction. SEE REV S • E FO 0 ED INSPECTIONS
SIGNATURE OF APPLICATION §242/§13
OWNER OR AGENT (� � DATE
SPECIAL APPRgK/ALS
PRELIM. FI LJ DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FO NOTICE)
/ems r—
/
P6/2)--LP1.-4)
i1 /die—.
1-- S,,vfk
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
e>�
CII crnev
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
3. a * 5, O
DATE ISSUED PERMIT NO. z TOTAL