1983, 08-24 Permit: 83A-8132 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARtMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
,A
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS l PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
QVUeR �► PHONE PHONE {
/3•
MAILIDDRESS ZIP
LZ Actual Set Backs in Feet to: _
X }
North South East I West
NTRACTOR
V esy
LICENSEE PIRES,
PHO
Size of Parcel
Zone Classification
Residential
Commercial L1
D KESS
ZIP
-71
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
�IEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
OFPE
WORK ❑ BLD. > PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑OTHER
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK I/�'
Shorelines/ Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
a
SOURCE
OF
GAS
ELECTRIC WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
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 provisions of any other state or local
law regulating construction or the performance
of construction. SEE REVE DE FORjW0UIRfD INSPECTIONS
Plumbing
SIGNATURE OF
APPLICATION
OWNER OR AGENT
DATE
Mech.
SPECIAL APPR V S
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FI DATE
Plan Check
Env. Health
SEPA
Planning
Fi
Ids j
Modular/
MFG. Home
re
Prevent.
L a
Engineer
Other (Specify)
Utilities
TOTAL $ -
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Y
Building08-24-83 813,26 *45.00°
Tech, y� I N 180 DAYS
C DATE ISSUED PERMIT NO. TOTAL
a
O
V
W
J_
LL