1984, 04-05 Permit: 84A-3007 Plumbing Fixtures PLAN NUMBER APPL ICAT ION./PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 634 - Oo7
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. /3O6—pg tJaw 7k€4. 4---J
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWN ,/ PHONE PHONE
3.
MAILING A RESS " ZIP Actual Set Backs in Feet to:
North I South East I West
C TRACTOR _ LICENSE EXPIRE Py,Qr E Size of Parcel Zone Classification Residential❑
4. kt�4 W fess`i -4<L '{'a.3' c/g i-3 t?3 Commercial❑ li 3 * * I)
ADDRESS ZIP Type Const. Occupancy ❑Yes Spr❑kl red ❑Req'd. '� -' 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 1-,
5. c, i' ,,, 6 '
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. f (1 i n
No.Baths No.Floors , No.Fin.Rooms No.Dwellings
TYPE 45-NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. &PLMB. ❑ MECH. ❑ M.H. ❑ POOL CCrVariancemp. Required Yes❑ No❑ Number
Received Yes No❑
DESCRIBE WORK • Shorelines/Flood Hazard Plans Required❑
8.
020 8. Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLIC SEPT CGE❑ Ownership FEES COLLECTED
9. LI
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 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 �O err—
of construction.SEE REVERSE IDE EQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION / ii._ gy
OWNER OR AGENT DATE Mech. i
SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE) i
Plan Check
PRELIM. FINAL DATE lt�e ,
Env.Health
if &t� SEPA
Planning p2 ra,�0ir Modular/
a8Y MFG.Home ›-
rs
Prerevent . a 5 m19 v d
Engineer Cs.-44 Other(Specify) W ,
9 J l
w,4 6/1
Utilities ,y_o
TOTAL $ .�—
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 COMMENCED ((� Q/� (� Q n n
Budding �� IN 180 DAYS DATE4S,UEW - U `'i PERMITN8.U, 7 z * 9 a 0 0 ROAL
Tech. S