1983, 08-18 Permit: 83A-7951 Plumbing FixturesPLAN NUMBER
CU
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
1.
2.
STREET ADDRESS
LOT
BLOCK
SUBDIVISION
r
WINER
>� t;
3.MAIL( ADDRESS
E. )019,1 y P
PHONE
/
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
4�j
TRACTOR i
. K i �f i' �J t jt.( MIA,'r�.
�(1/l2RESS r)I�7�C qi
DESIGNER
ZIP
Actual Set Backs in Feet to:
North (South
5.
ADDRESS
L}C?XPIRES
PHONE
ZIP_
Size of Parcel
11 Zone Classification
East
West
Type Const.
Occupancy
Residential 0
Commercial E
Sprinklered
❑Yes ❑No ❑Req'd.
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE XNEW ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF
WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H.
❑ MVE.
El POOL ❑ OTHER
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Remode ed Valuation
Total Bldg. Floor Area
Upper Floors
Greenhouse
Uncv. Deck
No. Floors
Fin. Basement
Unfin. Basement
No. Fin. Rooms
No. Dwellings
Required Yes❑ No
Received Yes❑ No
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Ownership
Public 0 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 t . provisions of any other state or local law regulating construction or the performance
of construction. SEE REV • ;• DE FOR RE REDDt)1SPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPR
PRELIM. FINS DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
f,
APPLICATION// ,C)/F2-
DATE ( J
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR%NOTICE)%��4
/4414
Oeve9ra-e4)ed
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
771
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-18-83
DATE ISSUED
795,12 *45.00°F
PERMIT NO. TOTAL
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I 1 �APPL (CANT �yt �fE�P ' 1 FLOWER �i(/ , T
-JOB NO. /97
FHA -CASE NO.
WATER L-Orr/Sa
SCALE 1 " = 20'