1983, 09-06 Permit: 83A-8632 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
LOT
2.
11 BLOCK SUBDIVISION
412623 A-et_r %
PARCEL NO.
OWN
Tref r 1♦ ..I- a/`.
3 ILING ADD
F.M raga
4. L�gEss vt7k <Y2*
5.
PH NE
a 1 �99i
PHONE
LEGAL DESCRIPTION:
Z0.707/4
Actual Set Backs in Feet to:
North (South (East [west
DESIGNER
LICENSE FJ�Plf7
PHONE
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
New Const. Valuation
Residential 0
Commercial 0
Spr nklered
EYes CNo CReq'd.
Remodeled Valuation
Total Bldg Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE XNEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7• OF
WORK BLD.PLMB. 0 MECH. 0 M.H. 0 POOL
8.
9.
DESCRIBE WORK
VALUATION
SOURCE
OF
UTILITIES
GAS
1ELECTRICC lure' WATER
PUBLIC O
PRIVATE 0
0 OTHER
SEWAGE
SEPTIC 0
SEWER 0
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifl. of Exempt.
or Variance
Shorelines/ Flood Hazard
Ves° Not Applic. 0
Ownership
Public 0 Private 0
Required Ves° NoD
Received Yes° No❑
1 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 notpresumeto give au-
thority to violate or cancelthe�y.v ..ns of any other state or local law regulating construction or the performance
of construction. SEE REVE
tilt?
FOR RE •y; D IN -I. ECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPRO
PRELIM. FIN DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
11
740
APPLICATION Gs� i
DATE / j�
SPECIAL CON (TIONS: (SEE REVERSE SIDE FOR NOTICE)
fr%/ GU -tel
/- /-
/r44I
dei
(/ At -
! i
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Requ red °
Received 0
FEES COLLECTED
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
is O
Other (Specify)
TOTAL $
PE MIT UMBER
�� - 27b,Z
03* *45.00
*45006
A *0.00 3
863.1
09-06-83
6479.
d
O
V
W
— J
W
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09"06-83
DATE ISSUED
PERMIT N0. 3' 2 Z *45.0 O WEAL