1983, 08-05 Permit: 83A-7403 Lawn Sprinkler SystemPLAN NUMBER APPLIICAT ION/PERMIT PERMITNUMBER
SPOKANE COUNTY -- DEPARTMENT OF BUILDING & SAFETY 65,A
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
E • ul (e rv"O .'s
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
PHONE
PHONE
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
f ��'rl(, I s C H 1qN
04e/'tZ
North South East
West
CONTRACTOR LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 71
Commercial ❑
4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
zee' 2_'}- N LPC.C.`tS t'
t4)L
Eyes ❑No ❑Req'd.
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
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. ❑ AD' N. El RPL. ❑ MVE.
%.
❑OTHER
dPLMB.
WORK ❑ BLD. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes El No❑
Number
or Variance
Received
Yes❑ Noel
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
8•
LA "t C, �? fL tN ���'rC
Yes 1:1 Not Applic. ❑
Received ❑
VALUATION
I SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
I SEWAGE
SEPTIC 1-1
Ownership
FEES COLLECTED
FEES
9
UTILITIES
PRIVATE El
SEWER El
❑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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE E SIDE FOR REQU E INSPECTIONS
Plumbing "I • t✓ti'
SIGNATURE OFQ APPLICATION �� �•
t7WNFR nR AGFN. / ilA�C1LrC L DATE __ -_— �-y_'.l ! D
Mech.
SPECIAL APPROVALS SPECIAL CONDIT , NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Prevent
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 1 a IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $Q 06 I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATB-MS'SUg� 8 J• PERMI;4.0• 5 dZ
* 9.0 0 QOTAL
C
C
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