1984, 04-24 Permit: 84A-3716 Plumbing FixturesPLAN NUMBER
APPLICATLON/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
STREET ADDRESS
1.
/69/3r/3' " /4e55e0 0
PARCEL NO.
2.
3
4.
LOT
OWNER
BLOCK
MAILING ADBRESS
SUBDIVISION
PHONE
LICENSE EXPIRES
40073-6Y
PHONE
ZIP
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North ISouth
Size of Parcel
East
West
Zone Classification
Residential 0
Commercial 0
ADDRESS
/32o3
%2 PC
Type Const.
Occupa cy
Sp nklered
DYes 0 N 0Reg 'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin Basement
Un/in Basement
TYPE
7. OF
WORK
f�l NEW 0 ALT. 0 AD' N. ❑ RPL. 0 MVE.
0 BLD. «PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No Baths
No. Floors
No. Fin. Rooms
No. Dwellings
CertifI. of Exempt.
or Variance
Required Ves❑ No0
Received YesO Non
Number
8.
DESCRIBE WORK
.7O
rzie-
Shorelines/Flood Hazard
VesO Not Applic.0•
Plans Required 0
Received 0
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that 1 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 -
f any other state or local law regulating construction or the performance
OUIRED INSPECTIONS
thorlty to violate or cancel the provision
of construction. SEE REVER
s'
D
OR
SIGNATURE OF
OWNER OR AGENT
/at -
APPLICATION,yr/
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
710/
SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE)
/z(ca-t,
(g.rvS
O reU,i s
s Leta
a5�c
aw
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/
MFG. Home
Other (Specify)
90 45 -
TOTAL
TOTAL $ 90 e
PERMIT NUMBER
—371(0
03* .*9Q00
*90008
A *000 8
371.32
04-24-84
2 6479.
D.
0
W
IA
J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
w!
ED2..4 = 8 4
PERMITLI L V Z
*9 a00mtAL