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1983, 07-27 Permit: 83A-7045 Plumbing FixturesPLAN NUMBER APPL LCAT ION /PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHIWGTON 99260 / (509) 456-3675 TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES PRIVATE ❑ SEWER ❑ STREETADDRESS ❑ POOL El OTHER I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on PARCEL NO. reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Certif Lof Exempt. Required Yes❑ No❑ Number of construction. SEE REV S 1 E FOR IRE qINSPECTIONS or Variance Received Yes❑ No❑ OWNER OR AGENT 2 DATE 71 LOT BLOCK SUBDIVISION Plans Required ❑ — 1— LEGAL DESCRIPTION: Yes Not Appiic. ❑ Received ❑ 2. SOURCE OF I ELECTRIC WATER PUBLIC ❑ SEWAGE SEPTIC ❑ Ownership SEPA Modular/ FEES COLLECTED 01Vi IMER PHONE PHONE Vlk � !•✓ MFG. Home 3. !u e_T- _'ZXA., Prevent. � l !'�i Ga 2 MA, LINd ADDRESS ZIP Actual Set Backs in Feet to : Other (Specify) Enaineer I rEw North South East West CrafQJRACTOR LICENSMS PHQNE Size of Parcel -' Zone Classification Residential ❑ Commercial ❑ 4 C, t- z2� 14J2 I" J ESS &99 ZI Type Const. Occupancy Sprinklered Dyes ❑No ❑Req'd. DESIGNER 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 Uncv. Deck Fin. Basement Unfin. Basement 6. No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. PRIVATE ❑ SEWER ❑ % OF WORK ❑ BLD. �PLMB. ❑ MECH. ❑ M.H. ❑ POOL El OTHER 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 Certif Lof Exempt. Required Yes❑ No❑ Number of construction. SEE REV S 1 E FOR IRE qINSPECTIONS or Variance Received Yes❑ No❑ OWNER OR AGENT 2 DATE 71 8 DESCRIBE WORK SPECIAL APPRO AL Shorelines/ Flood Hazard Plans Required ❑ — 1— Plan Check Yes Not Appiic. ❑ Received ❑ VALUATION SOURCE OF GAS ELECTRIC WATER PUBLIC ❑ SEWAGE SEPTIC ❑ Ownership SEPA Modular/ 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 Building 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 t r isions of any other state or local law regulating construction or the performance of construction. SEE REV S 1 E FOR IRE qINSPECTIONS Plumbing SIGNATURE OF APPLICATION OWNER OR AGENT 2 DATE 71 Mech. SPECIAL APPRO AL SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE j� `� /� ✓ ( l Plan Check Env. Health J — �G 1 �� r SEPA Modular/ Planning Vlk � !•✓ MFG. Home Fire Prevent. � l !'�i Ga 2 ��- Other (Specify) Enaineer I i /- r' k=�-- Plans PERMIT IS NONTRANSFERABLE Exam. 4PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building '\ / IN 180 DAYS PERMIT NUMBER 2� TOTAL $ __1�L._`'�-' WHEN MACHINE VALIDATED IN THIS SPAC THIS BECOMES A PERMIT. DATE ISSUED PERMIT NO. *45.00a�j- TOTAL CL O V W i LL