1983, 10-31 Permit: 83B-161 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
1.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
LOT
2.
BLOCK
7D7 / eit_rc,r&,
SUBDIVISION
PARCEL NO.
OWNER.-
r
LING ADD E
1,2 F.Vg
•CryFACTOR
4. pp��qq ¢/ �L!t' YC:/
ss
1 "e°t. 160K,
DESIGNER
5.
ADDRESS
PH E
asrisri
LICENSE FE)_R[S
PHONE
ZIP77.7/6
PH NE
3/:7
PHONE
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North (South (East I West
Sire of Parcel 1 Zone Classification
Type Const.
Occupancy
New Const. Valuation
Residential 0
Commercial 0
Spr nklered
OVes ONo OReq'd.
Remade ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
TYPE
7. OF
WORK
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Untin. Basement
%NEW ❑ ALT. 0 AD' N. 0 RPL. 0 MVE.
0 BLD. 1W.PLMB. 0 MECH. ElM.H. 0 POOL 0 OTHER
No Baths
No. Floors
No. Fin Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes° No0
Received Yes° No
Number
8.
DESCRIBE WORK
`? 1±-/'X Jtc re.'s
Shorelines/Flood Hazard
YesO Not Applic. 0
Plans Requ red O
Received 0
VALUATION
9.
SOURCE
UTILITIES
GAS I ELECTRIC
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 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 nl t'presume to give au-
thority to violate or cancel the oQ. ions of any other state or local law regulating construction or the performance
of construction. SEE REV J FOR R ED IN IV ECTIONS
SIGNATURE OF
OWNER OR AGENT K!�
DATECATION/Q /�/>»�'
SPECIAL APPRO
PRELIM. FIN '� DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOT CE)
A—/e9/c7
-
Y 5.:,�
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
6-0
Other (Specify)
TOTAL $ 1jCO
PERMIT NUMBER
.%17 '(C/(
03* *41.00
*41.006
A *GOO 8
110,02
1.0-31-83
2 6479.
d
O
W
-J
CZ
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
110 .41.
): 1-1`, 4. 8''3' l
DATE ISSUED PERMITN.J.� 2
1
* 410 0, QUAL