1983, 10-24 Permit: 83B-789 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
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
STREETADDRESS PARCEL NO.
2. LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
OWN&R-' ,/ t PFjQNE PHONE
3. LING AbdhESSZIP Actual Set Backs in Feet to:
North South East West
i�ILICEEM Size oParcel Zone Classification �OCommercial
4. SS t - �j Type Const. Occupancy Sprinklered
]3
Dyes ❑No ❑Req'd.
DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
5.
ADDRESS ZIP Mai Floor Upper Floors Garage/Storage Greenhouse
6. CHANGE OF USE FROM TO Covt Deck I Uncv. Deck Fin. Basement Unfin. Basement
TYPENEW 11 ALT. ❑ AD' N. 11 RPL. ❑ MVENo. the No. Floors No. Fin. Rooms No. Dwellings
.
OF
7 WORK ❑ BLD. KPLMB. ❑ MECH. ElM.H. ❑ POOL El OTHER CertIfk of Exempt. Required Yes❑ No❑ Number
orVarnce Received Yes❑ No❑
DESCRIBE WORK ; orelines/Flood Hazard Plans Required ❑
8fes ❑ Not Applic. ❑ Received ❑
VALUATION I SOOUFCE GAS ELECTRIC PUBLIC WATER SEPTIC GE ❑ Owne�hip FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER ❑ Publip ❑ Private ❑
1 hereby certify that I have read and examined this application and have read the "NOTI " providions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordina ces governing this type of
work will be complied with wh er pecified herein or not. The granting of a permit d s not presume to give au-
thority to violate or cancel th pr v' ns of any er st a or local law regulating const ction or the performance i �,
of construction. SEE REVE E E lFOR R UI D INSPECTIONS ('� Plumbing
SIGNATURE OF APPLICATION J/ Mech.
OWNER OR AGENT DATE Lv/ Ui
SPECIAL APPROV
PRELIM. FINAI
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR ISI �.let ef
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THISj1BECO2MES A PERMIT. J
DATE ISOSUED _ / PERMIT NO.8' 9 z
* 4 5.0 0 iO]FdTAI
u