1983, 11-15 Permit: 83B-1647 Sink, DishwasherPLAN 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
2.
STREET ADDRESS /—
ii/
LOT SUBDIVISION "'
BLOCK
PARCEL NO.
3. OWNER If -L'] 1.&„ l iefit &,
MAILING ADDRESsSy�
`7? , [1 04 yieirsF
CONTRACTO t
Peh4-ohcA21_
4.
5.
ADDRESS
/MA 3707
DESIGNER
ADDRESS
PHONEMk -49
PHONE
LEGAL DESCRIPTION:
ZIP
LICENSE EXPIRES
/n J
PHO E
<r /17G
Actual Set Backs In Feet to:
North (South [East I West
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
:Nes DNo °Rasa.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Fioor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin Basement
Untie. Basement
TYPE 0 NEW 0 ALT. 0 AD' N. j RPL. 0 MVE.
7. OF
WORK 0 BLD. fJl PLMB. 0 MECH. 0 M.H. 0 POOL 0 OTHER
8. DESCRIBE WORKeta Ada( � (/. 4i3/zt / ,
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE:MC
SEWAGE
SEPTIC 0
SEWER 0
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Cab/i. of Exempt.
or Variance
Required Yes° No0
Received Yes° No°
Number
Shorelines/Flood Hazard
Yes❑ Not Apolic.0
Plans Requ red D
Received 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 the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONSSIGNATURE OF
,/'
OWNER OR GENT _w ✓z ` ei-r,DATE',�
APPLICATION I ��j(
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Rre
Prevent.
Engineer
Utilities
SEPA
Rare
Exam.
Building
Tech
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
z F )CYGigE1-5
C4a1(Altczho
PERMIT 15 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 $ /5a1
PERMIT NUMBER
83E- 16LF7
C3*
A
164,62
11-15-83
2 6479.
* 13.00
* 1300
* 13.006
*000 8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11=15-83. 1647 *13,0'0
•
DATE ISSUED PERMIT NO. TOTAL