1983, 08-29 Permit: 83A-8293 Sprinkler System PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY ?A -522
?
GNORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ti • 1 toiz.40. 9
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
3. OWNfER ONE PHONE "
� ' r' C7 W-
V �4-- J
V
MAIILINg ADDRESS r �� ' Actual Set Backs inl South East I West
t to:
N J
CONT A T FeLICENSEEXPIRES HONE Size of Parcel Zone Classification Residential
4. Commercial 0
ADD ESS ZIP Type Const. Occupancy Sprinklered
❑Yes 0 N ❑Req'd. 4 J *
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - ;l, " _
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement 1J ', 2
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF
TYPE NEW ❑ ALT. D AD'N. ❑ RPL. D MVE. ❑ OTHER u 7 ',.
WORK
CI BLD. PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes 0 No❑
8 DESilINIniCRIBE WHrd Plans Required 0
IT VeaL] es Not Applicc..0 Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLIC WATER SEPTIC SEWAGE Ownership FEES COLLECTED
9 UTILITIES PRIVATE 0 SEWER 0 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 t .r.. sions of any other state or local law regulating construction or the performance 0=,of construction.SEE REVE 0E FOR RE ED CTIONS Plumbing �'
SIGNATURE OF / APPLICATION
OWNER OR AGENT -All-AN f /�� DATE 6 — .3 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home )-
Prevent. d
O
Engineer Other(Specify) C]
W
J
Utilities
of ii
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building V
%,-,
�" IN 180 DAYS (� R °1 n R n z 9 0 o fTech. C7 DATE ISSUED 2 7 —8 3 PERMIT, 2 9,3 z * Gro
iiL