1984, 02-15 Permit: 84A-1272 Plumbing Fixtures PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY J1A - (ii 2-
NORTH
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1 STREET ADDRESS/2/e P. £ l ANS PARCEL NO.
miC
LOT BLOCK SUBDIVISION V LEGAL DESCRIPTION:
2.
OWNERajO� . nLQ PHONE PHONE
3. MAILING ADDRESS !� ZIP Actual Set Backs in Feet to:
North (South [East I West
C9 ITRACTOR LICENSE EXPIgES P q� Size of Parcel Zone Classification Residential❑
C�O41✓�,tk�-�£��14r'<c 4�r L f/-.23�b�`( i"�z3 f�� Commercial❑ U * 1 0
4. AD �C/3 ZIP!
p7<G Type Const. Occupancy ❑Yea Spr❑Nor� ❑Req d 1 0 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 1 :__ 'i, 1 _:
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 VIEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. PLMB. 0 MECH. 0 M.H. ❑ POOL Certari Exempt. Required Yes❑ No❑ Number
or Received Yes No
8. DESCRIBE WORK a JK Shorelines/Flood Hazard Plans Required❑
Yes Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PUBLIC 0 SEPTIC❑
PRIVATE❑ SEWER 0 Public❑Private 0
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 provision • any other state or local law regulating construction or the performance
of construction.SEE REVERS --• OR R=P UIRED INSPECTIONS Plumbing
SIGNATURE OF 410 APPLICATION a��,.6-A-(
OWNER OR AGENT ''L - DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health tfp Ceo dC
6' aor b vg.1 SEPA
Planning /----DV r/ 5 4�'C't MMFG.Home y
Fire 0-
V. c-9--t/ O
Engineer 0 a..+4 6lSi Other(Specify) W
J
Utilities a-1041C
LL
, TOTAL $ /�6
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 COMMENCEDB1 1
Tech.n2 `S S IN 180 DAYS DATEEDL5 8 ,' PERMITFIa 7, 2 5 * 10 6" 0 0 L0,AL