1983, 09-01 Permit: 83A-8492 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
STREET ADDRESS ( PARCEL NO.
1. � S��ti��� ✓Ct.l �
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNEA- _� PHON. PHONE
3./
4. ' X i C c T_ tom, r kil /
DDRESS'at-)
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P,0, t7f)X :=S[ -TT
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM TO
s.
PHONE
Z --7,v_
ZIP
E
TYPE YNNEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 OF WORK 13 BLD. XPLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
North
Size of Parcel
Type Const.
Main Floor
Cover Deck
No. Baths
South I East I West
cone i iassmcauon Residential ❑
Commercial ❑
Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
n Remodeled Valuation I Total Bldg. Floor Area
Upper Floors IGarage/Storage I Greenhouse
No. Floors No. Fin. Rooms No. Dwellings
Required Yes❑ No El Number
PERMIT NUMBER
AC
TecBuildh.ing
IN 180 DAYS 09-01-b3 849,25 *45.00°
l DATE ISSUED PERMIT NO. TOTAL
O
C
C
U
U
or Variance
Received
Yes❑ No❑
DESCRIBE WORK��
8•
Shorelines/Flood Hazard
Plans Required ❑
—� )-
Yes Not Applic. ❑
Received ❑
VALUATION I SOURCE
9•
GAS ELECTRIC PUBLIC ❑ SEPTIC ❑ Ownership
FEES COLLECTED
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
thority to violate or cancel the
oA I ns of any other state or local law regulating construction or the performance
�•-�
of construction. SEE REVER
FOR REQ IRED NSPECTIONS
Plumbing A
SIGNATURE OF
APPLICATION
OWNER OR AGENT
L DATE
Mech.
SPECIAL APPRO A
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
,_L7
PRELIM. FINAL DATE
)✓ ` J
Plan Check
Env. Health
�I
uL Z �91ttL��L z' Y
SEPA
Planning
Fire
/ fi i (� / — /, ��
Modular/
MFG. Home
Prevent.
Engineer
�t2.(�
J
Other (Specify)
Utilities
TOTAL $
SEPA
MACHINE 1N
Plans
PERMIT IS NONTRANSFERABLE
HEIS BECOMES A PERMIT.
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
i
PERMIT NUMBER
AC
TecBuildh.ing
IN 180 DAYS 09-01-b3 849,25 *45.00°
l DATE ISSUED PERMIT NO. TOTAL
O
C
C
U
U