1983, 09-29 Permit: 83A-9669 Plumbing FixturesPLAN NUMBER
APPL LCAT ION /PERMIT PERMIT NUMBER
No. Baths
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETYn
No. Fin. Rooms
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
7. OF —//
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
PARCEL NO.
1. 4�> .
& t l V -V1 k4 Q , -- vv.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
WORK ❑BLD. GdPLMB. ❑ MECH. ❑ M.H. ❑ POOL
2.
or Variance
Yes❑ No❑
OWNER
DESCRIBE WOFIK
8.
PHONE
PHONE
3.
Z }r LNC7C t
Yes Not Applic. ❑
Received ❑
MAILING ADDRESS
SOURCE
OF
ZIP
Actual Set Backs in Feet to:
5 &o
A t2_ty'-\IV\.
q Zo
North South East West
FEES COLLECTED
CONTRACTOR
UTILITIES
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
1C" <
4. W11 iC_-r,`5 -t-7,1-"
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
5(� `7
All provisions of laws and ordinances governing this type of
Commercial ❑
not. The granting of a permit does not presume to give au-
ADDRESS
thority to violate or cancel the provisions of any other state
ZIP
Type Const.
Occupancy
Sprinklered
1✓ - l LISI,
MC UC_tc
ele
OWNER OR AGENT
Dyes ❑No ❑Req'd.
Mach.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
s. CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
TYPE 0 NEW ❑ ALT. 0 -'AD' N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
7. OF —//
❑ OTHER
Building
Certifi.ofExempt.
--FReceived
Required
Yes❑ No❑
Number
WORK ❑BLD. GdPLMB. ❑ MECH. ❑ M.H. ❑ POOL
or Variance
Yes❑ No❑
DESCRIBE WOFIK
8.
Shorelines/ Flood Hazard
Plans Required ❑
Z }r LNC7C t
Yes Not Applic. ❑
Received ❑
VALUATION
9•
SOURCE
OF
GAS
ELECTRIC
WA7
I TER
O
SEPTAL D
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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 the provisions of any other state
or local law regulating construction or the performance
of construction. SEE RE ERSE SIDE FOR R,&QYOEJD LhSP
I NS
Plumbing 1-3 _00
SIGNATURE OF
APPLICATION
OWNER OR AGENT
DATE [6
Mach.
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Plans
Scam.
Building
4DITIO E REVERSE SIDE FOR NOTICE)
i N Za
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
DATE RUED
IN
966.9
PERMIT NO.
*13.00°_�J-
TOTAL
O
C
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