1983, 06-29 Permit: 83A-5959 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 0', 5,57
C- NORTH 811 JEFFERSON /SPOKANE,V A. SHINGTON 99260/ (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. gD,5- U. ,SSI,ems -& 7
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. (Y44-4-y4
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North 'South East I West
CONTRACTOR LICENSE EXPIRES PH NE Size of Parcel Zone Classification Residential❑
+[0D S�'f!`
4il{2M.c/ifg)Z#04; ic_, � s'"`'?(3, s'"`'?( r-2y:3l?St3,, Commercial❑ 3 * * (t 7. C
4. ADDRESS ZIP Type Const. Occupancy ❑Yes Sprinklered
❑R 1� `
/,3:z/3:2c'---3 c_:. F'o�.�Cr/L g9‘0?f,C eq'd. T (z 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area F * C , ,
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - Y 5.8 `.
CHANGE OF USE FROM IO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
i16-L9-C3
6. h /i.7r;
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ,NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. ,�'PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
8. DESCRIBE WORK Shorelines/Flood Hazard I Plans Required❑
(// r((7D l.sS Yes El NotApplic.0 Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC❑ SEPTIC 0
PRIVATE 0 SEWER 10 Public❑Private El
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 the provisions of any other state or local law regulating construction or the performance /14 er_-
of construction.SEE REVERSE S •E F• ; REQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE '2?-83 Mech.
SPECIAL APPROVALS' SPECIAL C•NDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health 24
2 CSS/u SEPA
r
Planning I <� Modular/
Fire / `Skc E.- MFG.Home
Prevent. () /'v4S6'1 a
O
Other(Specify) v
Engineer ( r---,-0 Other
I Se04 J
Utilities I !v<4 LL
SEPA 1 5'�
ac�'�t �fP'yo'.rc TOTAL $ 1-7'7'5"
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 G 6 3 �j 9 o O J
Tech. , DATE ISSUED 2 9 _8 " PERMIT f7O 5.9 z *4 0' O 08Tki