1983, 06-14 Permit: 83A-5267 Lawn SprinklerPLAN NUMBER
APPLICATION/
SPOKANE COUNTY — DEPARTME9
'R M IT
BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, Wk ,— CN 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.) 404- l.c.)aoa.1',
PARCEL NO.
LOT
2.
BLOCK � SUBDIVISION
3.
OWNER
LE7—CW u.3 PCn1v6 Q.
MAILING ADDRESS
>r • t•14o.4"
PHONE
PHONE
G' 7•$—S I Co k
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North I South East I West
4.
5.
CONTRACTOR
SAVVLC
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ADDRESS
C✓il yYLE
DESIGNER
ZIP
Type Const.
Occupancy
Spr'nklered
OYes DNo OReq'd
PHONE
New Const Valuation
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 Nr NEW ❑�//A�LT. 0 AD' N. ❑ RPL. ❑ MVE.
7. OF 0 BLD. (AMR. 0 MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif I. of Exempt.
or Variance
Required Yes D No❑
Received VesO Non
Number
8.
DESCRIBE WORK
LRwra'Pat N C4E
9.
VALUATION SOURCE
UTILITIES
t - 5 SCE,v�
GAS ELECTRIC
Shorelines/Flood Haza d
YesD Not Apollo. 0
Plans Requ red 0
Received 0
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 compiled 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' . SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OFA PPLOWNER OR GENT B• /rte DATECATIO/_ `, ? 3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT 15 NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing `-'L•�7�
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ a `C'o
PERMIT NUMBER
S 311 5261
03*
5266
06-14-83
2 6479.
*9.00
d
CO
V
W
J
LA -
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DAT UE
EQSEDL: SU4 = 8 3
PERMIT52. U.7 i
* 9.0' U a°aTAL