1983, 10-03 Permit: 83A-9818 Mechnical FixturesPLAN NUMBER
APPLICATION /PERMIT
No. Fin. Rooms
No. Dwellings
TYPE ❑NEW El ALT. ❑ AD'N. 1:1 RPL. ❑ MVE.
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
(`
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
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STREET ADDRESS f
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PARCEL NO.
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8. DESCRIBE WOR
ines/Flood Hazard
rPublicD
LOT
BLOCK
SUBDIVISION
Received ❑
LEGAL DESCRIPTION:
2.
ELECTRIC
WATEPUBLIC R
❑
SEWAGE
SEPTIC ❑
OWNE f
p
PHONE
PHONE
3.
PRIVATE ❑
SEWER ❑
:2
I hereby certify that I have read and examined this application and have read the "NOTICE" providions included on
MAILING ADDRESS
�—.,
ZIP
us t Backs In Feet to:
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
North South East West
SIGNATURE OF APPLICATION C�
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CO TRACTOR f
OWNER OR AGENT DATE
LICENSE EXPIRES
SPECIAL APPROVALS
Size of Parcel
Zone Classif ication
Residential ❑
Plan Check
PRELIM. FINAL DATE
`
�`o
Commercial ❑
4.
�% `�
SEPA
Planning
ADDRI
`rL
ZIP
Type Const.
Occupancy
Sprinklered
tIQ 2/0
e. r'.�tn
MFG. Home
Fire
❑Yes ❑No ❑Req'd.
DESIGNER
Prevent.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Other (Specify)
Fnniru .r
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I
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
6.
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buildingjob IN 180 DAYS
Tech.
TOTAL $ ��
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
PERMIT NUMBER
D —
DA419IJEPERMITN0.11 8 z * 19- a 0 Qd'TAL
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No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑NEW El ALT. ❑ AD'N. 1:1 RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMB. N<MECH. ❑ M.H. ❑ POOL ❑OTHER
empt.
Required Yes❑ No❑
Number
Received Yes❑ No❑
8. DESCRIBE WOR
ines/Flood Hazard
rPublicD
Plans Required ❑
yesNot Applic. ❑
Received ❑
VALUATION
SOURCE
ELECTRIC
WATEPUBLIC R
❑
SEWAGE
SEPTIC ❑
FEES COLLECTED
9.
UTILITIES
PRIVATE ❑
SEWER ❑
ivate ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" providions 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 APPLICATION C�
r ` + l- k-
Mech. �, l
OWNER OR AGENT DATE
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Fnniru .r
I
I
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buildingjob IN 180 DAYS
Tech.
TOTAL $ ��
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
PERMIT NUMBER
D —
DA419IJEPERMITN0.11 8 z * 19- a 0 Qd'TAL
C
C
C
L
L