HomeMy WebLinkAbout1984, 01-04 Permit: 84A-059 Plumbing Fixtures PLAN NUMBER APPLICATION/,,PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY g4A- — 0,�
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. /e 0 7 o C.4-/ l�1047 r_
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION:
2.
OWNE PHONE PHONE
u .‘ .$4«a�
3 cMAILING ADDRESS ZIP Actual Set Backs in Feet to:
North 'South East I West
CORACTOR LICENSE EXPIRES P O E Size of Parcel Zone Classification Residential❑
4. Ce"O 5EAc— it .i4. ro-c, le-w3-6 Y 'Taw f?� Commercial 0 * x ,r. .,
ADDRESS/2.20.3 r T-,7� ZIP Type Const. Occupancy Sprinklered
Gi ❑Yes 12 No ❑Req'd.
!J
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 :.i ` ,i ; — - `)
6. 4 f
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. El RPL. ❑ MVE.
7. OF ❑ OTHER
WORK El D. l(PLMB. ❑ MECH. ❑ M.H. ❑ POOL ayazianExempt. Required Yes No❑ Number
�\ Received Yes No❑
DESCRIBE WORK _ Shorelines/Flood Hazard Plans Required 0
8. /`f rl IC_ Yes❑ Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PUBLIC 0 SEPTIC 0
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 specif--• •- -in or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisio . of any of = state or local law regulating construction or the performance 6/4c—
of
of construction.SEE REVERSE - ' •R REQUIRE• INSPECTIONS Plumbing
SIGNATURE OF OWNER OR GENT k ' DATE APPLICATION % /!
7_ Mech.
SPECIAL APPRO • SPECIAL •NDITIONS: EE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health 34,..,6
#644,4-) SEPA
Planning I TU9 Modular/
0 " MFG.Home >-
Fire C.
Prevent. ` /04- v
Engineer c.b/ Other(Specify) W
9 I wlnr� J
Utilities &4/1 w
TOTAL $ C fes•
SEPA ..
4- 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 / IN 180 DAYS (('0 11 Q 4 _3
. ` o O
Tech. //� ! / DATE 151.— PERMIT NO. z * 61. 0 110tAL