1983, 04-07 Permit: 83A-2722 Plumbing FixturesPLAN NUMBER
1.
rs
TO
LOT
BLOCK
2.
Unfin. Basement
6.
OWNER
3.
L ikep_-y
MAILING ADDRESS
c�.4CU4\
No. Baths No.
CONTRACTOR
4.
t WC"' S>
T.
NEW ;�P`LMB.
% OF
ADDRESS
MFG.Home
W7 ;:!�Z-L —
DESIGNER
A
❑ MECH. ❑ M.H. ❑ POOL
ADDRESS
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
PARCEL NO.
SUBDIVISION I LEGAL DESCRIPTION:
I
PHONE PHONE
(5i
ZIP
LICENSE EXPIRES PHONE
ZIP
ae
PHONE
ZIP
PERMIT NUMBER
- Z ZZ
Actual Set Backs in Feet to:
North South East West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Ty= Occupancy I Sprinklered
❑Yes El No ❑Req'd.
New Const. Valuation Remodeled Valuation Total Bldg. Floor Area -
Main Floor I Upper Floors I Garage/Storage I Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
T.
NEW ;�P`LMB.
% OF
[�AD' N. ❑ RPL. ❑ MVE.
❑ OTHER
MFG.Home
Fire
WORK ❑ BLD.
❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes Ll No❑
Number
or Variance
Received
Yes El No❑
DESCRIBE WORK
8• '�3
Engineer
Shorelines/ Flood Hazard
Plans Required ❑
�= t VL
Yes El Not Applic. ❑
Received ❑
VALUATION
SOOUFCE
GAS
ELECTRIC
PULC WATER
SEWAGE
SEPT C El
Ownership
SEPA
FEES COLLECTED
9•
I
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
Plans
I hereby certify that I have re
and examined this application and have read the "NOTICE"
provisions included on
reverse side, and know the
correct. All provisions of laws and ordinances governing this type of
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
I N 180 DAYS
DATE (� !ES' /�
m O 7- 8 3
Building
Tech.
Building
work will be complied with
ified here) r not. T e granting of a permit does not presume to give au-
hZisions
thority to violate or cancel
prof any othe state local law regulating construction or the erform ce
of construction. S REV
R REQUI
Plumbing \ <C3�+
SIGNATURE OF
APPLICATPV 93
OWNER OR AG
�" DATE /
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
PERMIT 10. G 2 z * 17. 0 01�TAL
C
C
C
L
L
SEP,
Planning
Modular)
MFG.Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
I N 180 DAYS
DATE (� !ES' /�
m O 7- 8 3
Building
Tech.
7
PERMIT 10. G 2 z * 17. 0 01�TAL
C
C
C
L
L
N
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G