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1983, 12-22 Permit: 83B-2725 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT P RMITNUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETYk33 272 NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES S - ETADD-ESS PARCE6NO. l� - 1. -, = 4111► -., c,1811 Pre 7resc LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. • OWNER P ONE, PHONE 3. C--o vdcw p&l'�l�P_/ '29-144 MAILING ADDRESS ZIP Actual Set Backs in Feet to: North 'South East I West T LICEtNSE EXPIREf, Pcy�NE � Size of Parcel Zone Classification Residential❑ CC ' s y /✓�1�1 �j i � / 7"'�i�4 3 l C��` !©� Commercial❑ 4. ADDR//FFSSS„. �L ZZ) / Type Const. Occupancy Sprinklered �lts°!' �{�t�/y�J L / 2 '(O ❑Yes ONo ❑Req'd. DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse .. e.. CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement 6. _ No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE 0 NEW %ALT. 0 AD'N. ❑ RPL. ❑ MVE. 7 WORK ❑ BLD. f�PLMB. ❑ MECH. ❑ M.H. ❑ POOL 0 OTHER Certifi.of Exempt. Required Yes No❑ Number or Variance Received Yes No❑ DESCRIBE WORK /r Shorelines/Flood Hazard Plans Required CI Pl 4'G(AC Yes❑ Not Applic.❑ Received ❑ VALUATION SOURCEOGAS Cl1 ELECTRIC PUBLICO SEWAGE O Ownership FEES COLLECTED 9. UTILITIES PRIVATE 0 SEWER❑ 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 Building 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 the provisions of any other state or local law regulating construction or the performance �y of construction.SEE REVERSE SIDE FO Ef1UIRED INSPE I. NS Plumbing 7�-e`a SIGNATURE OF �/ APPLICATION OWNER OR AGENT DATE ��"� `� Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE j Plan Check Env.Health / Yr /l s _ 3 Z— �` 5 A SEPA Planning 3 & 1,4''S Modular/ Fire l14 4 MFG.Home >- 0- Prevent. O Engineer / S/oI.vL Other(Specify) 5--6 0 C;1 V W 'rMLf Utilities j — / f ✓ / t yr- _ -•..,-. �- TOTAL $ SEPA Plans e PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TEN MACHINE TED IN THIS SPACE, Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building `/r IN 180 DAYS Tech. ' /Z"� DATEYU8 3 a _ 0.L 0 * 3 7. oOJT AL2