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1983, 09-06 Permit: 83A-8638 Plumbing Fixtures
PLAN NUMBER APPL ICAT ION /PERMIT SPOKANE COUNTY -- DEPARTMENT OF BUILDING & SAFETY r NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 WORK ❑ BLD. 1p,�LMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES Number 1. STREET ADDRESS Received Yes❑ No❑ PARCEL NO. Hazard Plans Required ❑ I r, 7 G�c 6 LOT BLOCK VALUATION bUBDIVISIO14 k—J, GAS LEGAL DESCRIPTION: ER PUBLIC ❑ SEWAGE LiOwnership SEPTIC 1 2. FEES COLLECTED 9• UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑ OWW_%—' ,/" P NE reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of PHONE work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building thority to violate or cancel t visions of any other state or local law regulating construction or the performance 3. of construction. SEE REV R DE FO_RltfQUIKD INSPECTIONS r SIGNATURE OF APPLICATION OWNER OR GENT DATE Mech. ING AcbFIEss ZI Actual Set Backs in Feet to: r North South East West C00ACTOR �i1 LICENS E S P Size of Parcel Zone Classification Residential Commercial ❑ 4 (� eE Type Const. Occupancy Sprinklered ❑Yes ❑No ❑Req'd. ' aa DESIGII'ER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Unov. Deck Fin. Basement Unfin. Basement 6. PE No. Baths No. Floors No. Fin, Rooms No. Dwellings 7• NEW El ALT. 1:1 AD'N. ❑RPL. OF E) MVE. ❑OTHER WORK ❑ BLD. 1p,�LMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DESCRIBE WORKShorelines/Flood 8. �p Hazard Plans Required ❑ I r, 7 G�c 6 Yes Not Applic. ❑ Received ❑ VALUATION I SOOUFCE GAS ELECTRIC ER PUBLIC ❑ SEWAGE LiOwnership SEPTIC 1 FEES COLLECTED 9• 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 work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building thority to violate or cancel t visions of any other state or local law regulating construction or the performance of construction. SEE REV R DE FO_RltfQUIKD INSPECTIONS Plumbing _!vU SIGNATURE OF APPLICATION OWNER OR GENT DATE Mech. SPECIAL APPRO A S SPECIAL CO ITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINA DATE Env. Health n Planning / " > f=/e© r- Pr r-12-il � Fire Prevent. Engineer ✓Z_ j A Utilities V SEPA 1 6� Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Tech mg IN 180 DAYS Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ PERMIT UMBER . t%'� WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 09=`06-83 38G DATE ISSUED PERMI*141 *45-1 U ; TOiAL a C U W J LL