1983, 02-14 Permit: 83A-1082 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT UMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY - 1 0B�
0 ) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREEIADDRESS PARCEL NO.
1. p- - c-y,,, ,-i-iisr.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. a ,
3. Q� 1.... ..„...v
.j/ Y��� PHONE �I✓` _ i
MAI ING DRE `� Actual Set Backs in Feet to:
�� North 'South [East I West
CONT fulNJLICENSE EXPIRES 2HOSize of Parcel Zone Classification dentinial 0 i
4.
G6 7
Sprinklered
A ESS 117 �
7,-2_6)0 Type Const. Occupancy ❑Yes ❑No ❑Req'd. - s , -DESIGNER NE 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 Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE NEW 0 ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF � 0 OTHER
_
WORK ❑ BLD. F'LMB. 0 MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Veen No❑
8.
(
DESCRI5WOR ` Shorelines/Flood Hazard Plans Required❑
Y` L_ Yes Not Applic.0 Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLICO SPTIC SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PRIVATE❑ 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 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
of construction.SEE REVERSE SIDE FOR:0 •'l RE' IN • TIONS Plumbing
SIGNATURE OF / AO% APPLICATION_ L`2T
OWNER OR AGENT Q ' G / DATE 1
Mech.
SPECIAL APPROVALS SPECIAL'S•NDI "J j-: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health 2- GeCit
2 `vV G SEPA
Planning ''!!.II� Modular/
l V V[��/—• MFG.Home >-
Fire
a
Prevent. C
Engineer Other(Specify) C.3
W
J_
Utilities LL
_ TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Pxam
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED nn11 (� R
Bech.
uilding 4-- I N 180 DAYS DATEQS UED� 4 -8 3 PERMIT-IPA.8. 2 5 * 2 5, 0 0 1`OIFAL