1983, 09-20 Permit: 83A-9229 Plumbing Fixtures jPLANNUMBER IAPPLICATION/PERMIT0) SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY PI 1 ua
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. /g 0v R o /Ylc„� PARCEL NO.
LOT BLOCK SUBDIVISION t
2.
I LEGAL DESCRIPTION:
OWNERlas y� �r PHONE PHONE
3.. r M' C Y e! l �/ , `
MAILING ADDRESS y r/7�
ZIP Actual Set Backs in Feet to:
CONTRACTOR
North 'South East I1IVest
4. . ^ P /� I LICEN$ EXEg pl{O/N _i 6 13 Size of Parcel
yt N j 9 �r Zone Classification I
ADDRESS /V 7 c /, �z AGe E ZIP Type Const. Occupancy Residential❑
Commercial❑
gZc / Sprinklered
DESIGNER I I ❑Yes ❑No ❑Req'd.
PHONE New Const.Valuation I Remodeled Valuation I Total Bldg.Floor Area
J. ADDRESS
ZIP Main Floor 'Upper Floors IGarage/Storage I Greenhouse
CHANGE OF USE FROM I TO
Cover Basement I
erDeck IUncv.Deck jFin. Unfin.Basement
No.Baths 1No.Floors INo.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. CI RPL. CI MVE.
7. OF
WORK ❑ BLD• CIPLMB. CIMECH. GI M.H. CI POOL CI OTHER
CertlfiiRequired Yes No Number
or Varaof Exempt. I nce Received Yes❑ No❑
DESCRIBE WORK
8' Shorelines/Flood Hazard Plans Required ID
VALUATION SOURCE GAS ELECTRIC PUBLIC pYesp Not Applic.❑
Received ❑
9• SEWAGE Ownership
UTILITIESLIPRIVATE❑ SEPTIC❑ FEES COLLECTED
SEWER❑ Public❑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 the provisions of any other state or local law regulating construction or the performance Building
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF Plumbing
OWNER OR AGENT APPLICATIONDATE a
_
SPECIAL APPROVALS SPECT L CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Mech.
PRELIM. FINAL DATE
Env.Health Plan Check
. . IA vs I— (v/_I,
Planning 2 - n` ) ( SEPA
Fire 'J ' Ki Modular/
Prevent. 7 /Caid�Qs�i MFG.Home
Engineer C• I O ) �-
a
V h Other(Specify) C
Utilities C
2 _ 5k0v() I f XV 4t j w
SEPA j 9/ li
TOTAL $ r�
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Exam THIS BECOMES A PERMIT.
Building PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech. �rae,
IN 180DAYS qDATE4S6QUE� 0 —U 3 PERMI8.2, 9 z * 6 9, 0 OCTAL