1983, 08-23 Permit: 83A-8059 Plumbing Fixtures PLAN NUMBER APPLICATION, /PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTIVIENV OF BUILDING & SAFETY - bO I
C— NORTH
811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREfrADDRESS PARCEL NO.
LOT BLOC SUBDIVISION LEGAL DESCRIPTION:
2. / ff P� �j
3. 01V
. O,VyIv�I NWW� /O '7.-. 465rNE
MAILING ADDRESS ZIP G ZZIIP Actual Set Backs in Feet to:
R�
4- 2( 7�S ✓ North South East I West
CONTR LICENSE EXPIRES PHONE Size of Parcel
Zone Classification Residential❑
4. Commercial❑
ADDRESS ZIP Type Const. Occupancy
❑Yes ❑NSprillered
o ❑Raga.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.FloorArea 0 3 * f� .,
5. g1. ., 0
ADDRESS * G 1, Y
ZIP Main Floor Upper Floors Garage/Storage Greenhouse0
A * G. 0 3
CHANGE OF USE FROM TO Cover Deck . Uncv.Deck Fin.Basement Unfin.Basement
6.
805.8f
TYPE 0 ALT. 0 AD'N. ❑ RPL. CI MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings ;
7. OF c— —
❑ D.
BLMB. ❑ MECH. ❑ M.H. ❑ POOL El OTHER
WORK Certifi.of Exempt. Required Yes❑ No❑ Number __ r lI 7 r
or Variance Received Yes❑ No❑
8. DESCRIBORi)(./j ia..(5ri
Shorelines/Flood Hazard Plans Required El
Received Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9. UTILITIESLIPUBLICO
❑ SEPTIC El
Public❑Private❑ FEES COLLECTED
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 provisions of any other state or local law regulating construction or the performance
of construction.SEE REV SE SIDE FOR REOUI D INSPECTIONS Plumbing l .
SIGNATURE OF APPLICATION tyg
OWNER OR AGENT DATE Mech.
SPECIAL APPROVAL SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE �� Plan Check
Env.Health
I Planning
L..-,Pc )- SEPA
I C Modular/
Fire MFG.Home
Prevent.
I KI'r.iNiK, 0
Engineer 0
Other(Specify) v
Utilities LLJ
J
LL
SEPA TOTAL $
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Exam. THIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech.ing ►411•x' 8i IN 180 DAYS (� R •� p Q (� n 1
7 DATE f55'CJED 2 3 —0 3 PERMIT NW 5.9 z * 2 1.0 GT®JtAL