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1983, 01-25 Permit: 83A-0615 Relocate Meter, Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 63A- " `'`3 C)C j NORTH 811 JEFFERSON/SPOKANE,WASHIIJGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 1. c :Cs+ O c e- LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. L, (1 * * 1 2 + 0 OWNER PHONE PHONE * 1 G, 0 0 3. k,F.:7L.><- ).% G'fz4=33P MAILING ADDRESS ZIP Actual Set Backs in Feet to: it * C ( b North (South `East I West F I, d _r CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ A ivc -.t 6'tt 1/4 . q Z4 `cP57 Commercial❑ 0 1 -2 5- s' 4. ADDRESS ZIP/, Type Const. Occupancy Sprinklered (+ . k 04e t "C"N ciciz ❑Yes ❑No ❑Req'd• .r 6 4 7 C 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 0 NEW VALT. 0 AD'N. 0 RPL. 0 MVE. 7. OF ❑ OTHER WORK 0 BLD. 0 PLMB. I'MECH. ❑ M.H. 0 POOL Certifi.of Exempt. Required Yes No❑ Number or Variance Received Yes❑ No❑ DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑ 8• 'RE C.. �Ak� ' .T.E(Z_ -Pt Pi V,4 Yes Not Applic.0 Received 0 VALUATION I SOD UTILITIES SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED 9 PUBLIC 0 SEPTIC 0 PRIVATE❑ SEWER❑ Public 0 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 REQUIRED INSPECTIONS Plumbing SIGNATURE OF 4') . DATEMech. A-t2 APPLICATION - S—ifJ' OWNER OR AGENT �A� SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE) �� Plan Check PRELIM. FINAL DATE 12_1 R k-Fl Env.Health SEPA Planning Modular/ MFG.Home Fire 12- Prevent. Prevent. v Engineer Other(Specify) W J Utilities ' TOTAL $ 1-2•_ SEPA WHEN MACHINE VALIDATED IN THIS SPACE, Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ((�� Teching I`ll- Ya.5/65 IN 180 DAYS DATE4SiUEa 5 -8 3PERMITNa. 5 Z * 1 2.0 0 ¢dTAI