1983, 09-12 Permit: 83A-8951 Plumbing FixturesPLAN NUMBER
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
STREET ADDRESS
1.
LOT
2.
BLOCK
t -i %0.s •Ci
SUBDIVISION
3. /IT,
(LING ADORESS
F /2- 9
CTOR
4pARE»
<.RAJ c; PC..
o ,�
DESIGNER
•
P ONE
,7 $9--/75/
PHONE
1z: f�
yiXPIRES
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
TO
TYPE NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
% OF WORK ❑ BLD. XPLMB. 0 MECH. 0 M.H. 0 POOL El OTHER
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
UTI LLIITI ES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North South
Size of Parcel
Type Const.
New Const. Valuation
Main Floor
Cover Deck
No. Baths
East
West
Zone Classification
Residential ❑
Commercial ❑
Spr'nklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Total Bldg. Floor Area
Garage/Storage
No. Floors
Certif1. of Exempt.
or Variance
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes CI No El
Received Yes ❑ No [7
Shorelines/Flood Hazard
Yes❑ NotApplic. ❑
Ownership
Public 0 Private 0
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 t r isions of any othertate or local law regulating construction or the performance
of construction. SEE REV RS • 1 s E FOIRE INSPECTIONS
SIGNATURE OF
OWNER OR,AGENT
SPECIAL APPROJ 4A
PRELIM. FIN L
$
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION 9J
DATE / %s2 /53
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
�GCGGa)otoi,
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED —
PERMIT NO. 5, z * 5. O O TOTAL
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ADDRESS 1Y 9215 ' /.L!/, +,• I STYLE HOME 99'9 3'F_ , T_'_j
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LEGAL DESC-ft1'PTiON -i-el'--1,- 13ik' - - t�fnq�# / . -,-- -i—!-
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APPl1CANT 7 POWER G(_ i �
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--4-
JOB NO. 4r.2 yy
--FHA -CASE •N0.
____WATER
SCALE 1 " = 20'