1983, 07-21 Permit: 83A-6781 Mechanical FixturesPLAN NUMBER APPL ICAT ION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
TYPE NEW ❑ ALT.El A 'N. El RPL.
L/ APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET
7 OF
11 OTHER
PARCEL NO.
WORK ❑BLD. ElPLMB MECH. ❑ M.H.
❑POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK `
8
LOT
BLOCK
SUBDIVISION crt cod
''orrest
plus
Yes❑ Not Applic. ❑
LEGAL DESCRIPTION:
VALUATION
2.
GAS
t
,.
SEWAGE
ElFEES
Ownership
COLLECTED
O d+J i `OSS
PHONES ,--4 7?
PHONE
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East West
CONT ACTOR ,
v lc3,rr "ir'0 1 n
LICGN XPIRES
L ' 1
PHONE �,
Size of Parcel
Zone Classification
Residential ❑
4.
,,.c.,
/ /
922-2', 60
Commercial ❑
ADDRESS
"P99
03?
Type Const.
Occupancy
Sprinklered
16610
❑Yes ❑No
❑Req'd.
DESIGNE9 L
Liesence VALLsF�S26:uv
�Y
PHONE
New Const. Valuation
Remodeled Valuation
Totai Bldg. Floor Area
5.
on.,r. „-
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
--_
CHANGE OF USE FROM
Cover Deck
Uncv. Deck
in. Basement
Unfin. Basement
6.
70
No. Baths
No. Floors
No. Fin Rooms
No. Dwellings
TYPE NEW ❑ ALT.El A 'N. El RPL.
11MVE.
7 OF
11 OTHER
WORK ❑BLD. ElPLMB MECH. ❑ M.H.
❑POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK `
8
-
hiov th oxtenS"
Shorelines/ Flood Hazard
Plans Required ❑
,_nlo masonryl
plus
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ElSEPTIC
SEWAGE
ElFEES
Ownership
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-
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 INSPECTIONS
SIGNATURE OF % APPLICATION_1 /,�?
OWNER OR AGENT I �� DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 47i f IN 180 DAYS
Buil
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
PERMIT NUMBER
.1
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. 7
DATE}SS71
UED2 1 - 8 PERMIT�O. V. 1 L
*20.00Oft t,L
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