1983, 05-31 Permit: 83A-4610 Mechanical FixturesPLAN NUMBER
1.
STREET ADDRESS
-72
LOT
2.
BLOCK
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
/7, 4'729
SUBDIVISION
PARCEL NO.
OWNER
MAILING ADDRESS
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North !South {East I West
CONTRA -) 1rll' C
-
4.
5.
O/(
ADDRESS Iri 506/
6 . e ,�
DESIGNER
LICENSE EXPIRES
e -e 75
Size of Parcel I Zone Classification
Residential ❑
Commercial ❑
Z9`1�i1to
Type Const.
Occupancy
Spr nklered
❑Yes 0 N ❑ Reg 'd.
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW 7ALT. ❑ AD' N. ❑ RPL. 0 MVE.
7.OF WORK El OTHER
0 BLD. ❑ PLMB.MECH. 0 M.H. ❑ POOL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No
Received Yes ❑ No❑
Number
8. DESCRIBE WORK -yy,� a42-, 4.
Shorelines/Flood Hazard
Yes ❑ NotApplic. ❑
Plans Requ'red ❑
Received ❑
VALUATION
9.
SOURCE
F
UTILITIES
AS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
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-
thority to violate or cancel • • • '•ns of any other state or local law regulating construction or the performance
of construction. SEE ERSE SID • R : • • REDINSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION 13/ /
DATE f
SPECIAL APPROVALS l
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
#31
ECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular(
7MMFFG. Home
/1
"ddOthe(Specify %G1 � v�
a ere
,/�' U3
TOTAL $
PERMIT NUMBER
8A —460 t'O
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEgSSU
D31-83
PERMITN9.1. 0 z
*12.00AL