1982, 12-01 Permit: 82B-1560 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. G- 17 /-0 6, Nj o -roki-f
LOT r BLOCK SUBDIVISION
2.
PARCEL NO.
4.•
LEGAL DESCRIPTION:
OW`blJer,f 141
MAILING ADDRESS
• 11406 r� AoM652,
CONTRACTpq
4.
ADDRESS
PHONE
9�8 - 5.
Pty7
PHONE
LICENSE EXPIRES
ZIP
9501
PHONE
Actual Set Backs in Feet to:
North [South
Size of Parcel
[East
Zone Classification
West
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr'nklered
DYes ❑No ❑ Req. d.
5.
DESIGNER
PHONE
New Const Valuation
Remodeled 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
Unlin. Basement
TYPE ZINEW
7. OF
WORK ❑ BLD.
❑ T. 0 AD' N. 0 RPL. 0 MVE.
PLMB. ❑ MECH. O M.H. 0 POOL
0 OTHER
No. Bath
No. Floors
No. Fin. Rooms
No Dwellings
Certitl. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE W0
8. J
es
Shorelin/Flood Hazard
Yes❑ Not Apollo. 0
Plans Required 0
Received 0
VALUATION
9.
S OF
UTILITIES
SOURCE
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE O
SEWAGE
SEPTIC 0
SEWER O
Ownership
Public ❑ Private 0
I hereby certify that 1 have read and examined this appl'cation 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 provisions of any other st.te or local law regulating construction or the performance
of construction. SEE R ER• E SID • R RE• • IR • SPECTIONS
SIGNATURE OF
OWNER OR AGEN
r
APPLICATION ��ii �7
DATE /Z - �'-/1 �—
SPECIAL APPROV LS
PRELIM. FINA / DATE
Env. Health
Planning
Eire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
1 kkr 4-111C-
61 ft -S
PERMIT 15 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)
TOTAL $ I7.
PERMIT NUMBER
- - 15(00
03* *17.00
* 1 7.006
A *0.00
15592
12-01-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE16. UEW '1 '— 8:2
PERMITIlG.b,O2 *17'00OOI-AL