1983, 05-13 Permit: 83A-4027 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY -A -4-e-z:7
NOATH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
. '. /7/ /, a KIs7
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER A�r PHONE PHONE
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North I South East I West -
CONTRAC k LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ ,
4. J '� / t„/r Commercial❑
AD/749-
D/�� ,C ZIP Type Const. Occupancy Sprinklered
7 — 5 f ,47 /..5'
❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 1EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. i1ECH. ❑ M.H. ❑ POOL Certi ii Exempt. Required Yes No❑ Number
or Varance Received Yes No
DESCRIBE WORK 'A , / / Shorelines/Flood Hazard Plans Required❑
8• /75
9 c71rj/J /Lp ,Ape,1,40
Yes Not A Hazard
❑ Received ❑
VALUATION SOURCE '� 'suu� GAS ELECTfxJ IC WATER SEWAGE Ownership FEES COLLECTED
PUBLICPRIVATE❑❑
SEPTIC❑
SEWER 0 Public 0 Private 0
9• UTILITIESO
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 n. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any othe - or local law regulating construction or the performance
of construction.SEE REVERSE S E FOR REQUI• ' NSPECTIONS Plumbing
SIGNATURE OF , APPLICATION ��3�,�� I� ��
OWNER OR AGENT ../ , ' , DATE c—� — Mech.
SPECIAL APPROVALS SPECIAL CONDITIO S: (SEE REVERSE SIDE FOR NOTICE)
Plan Check i
PRELIM. FINAL DATE
Env.Health ,
SEPA
Planning Modular/
MFG.Home a k
Fire
Prevent. COQ 1
Other(Specify) LU 1
C.)
Engineer
W
Utilities
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
Building IN 180 DAYS
Tech. 9n- ,;f/ DAT Ed 3 -8 3 PERMI1'NO.2,7 * 19. G 0 QOTAL