1983, 12-23 Permit: 83B-2767 Plumbing Fixtures(PLAN NUMBER I APPL IICAT ION /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
STREETADDRESS PARCEL NO.
c
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
O ER ��
PUPNE
PHONE
3.
AILING ADORES
ZIP
Actual Set Backs in Feet to:
f
North South East
West
C>qRACTOR
TICENSEE
IRE
PHONE
Size of Parcel
ZoneClassification
Residential
J ,'
4.
�.Z
Commercial ❑
D RE
'�
ZIP
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO— -
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TYPE �(VEW ❑ALT. 1:1 AD'N. El RPL.
El MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF
WORK ❑ BLD. XPLMB. ❑ MECH. ❑ M. H.
El POOL ❑OTHER
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ Non
8 DESCRIBE WORK
Z �/ L I
r
Shorelines/ Flood Hazard
Plans Required ❑
i X Lt
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
I SOOOF
GAS
ELECTRIC
WATER PUBLIC C1SEPT
SEPTIC
1
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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 p o 'sions of any other state or local law regulating construction or the performance
of construction. SEE REV RS E FOR R RED
SPECTIONS
Plumbing
SIGNATURE OF
APPLICATION
OWNER OR AGENT
DATE
Mach.
SPECIAL APPROV�
PRELIM. FINAL
Env. Health
Planning
Prevent.
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
DATE
c� ~ ie, 06
1
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ ' \
�RMII,T NUMBER
G/ '� I &
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. L 7
DATEIS�ED� _ 3 PERMIT NO. U / z
*61.00°
TOTAL
tL
O
U
W
J
U.
REVifiON RECORD I AUTH
r e
`OI UTILITY EASEMENT
1�
t o'
-PLOT -PLAN
• �i
SCALE: 1'i = 36-0"
Lo
Ice
Lu
LOT 3 _BLOCK
KANU)4A HILLS, F?RST Ar)DMOX
SPOKANE COUNTY WA,
NOV 3 0 383
'PARCEL NO. 23534-- 1243
—'�'�-- ACCESS EASEMENT TOLZRANCE3
(EXCE" All NOTED) FR1T Z J,.,/ A I 1 A X I C•
87.04
DECIMAL S, 4-(.2.1 FA RR RD, KALE DRAWN tY c. W. 4
C=3 i
S. KA,.{ NA t SPO KANE� WA. X9206 f =30 APPROVED BY
R • FRACTIONAL TITLE
ANGULAR DATE DRAWING NUMBER 7
t 1► -ZS -$3 I Rls— 1 + �- f of 4
KLj
«� ALMNENIt 0 10 SMW omm M Y. {. A.
YMNpM• RAft"as to" 204"