1984, 02-15 Permit: 84A-1274 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY g4A - 1714
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 992601(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
•
STREET ADDRESS .%) PARCEL NO.
1. 1706 • . itme-iso
LOT BLOCK SUBDIVISION r LEGAL DESCRIPTION:
2.
OWNEfy=c)• � ^44 S PHONE PHONE
3.
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North _South East I West
TR�JACTQR /, LICENSE EXPIRES PH NE Size of Parcel Zone Classification Residential❑
4.
4::7,140x,
SS�x, �lrA/Nvt`'�, 'L'L a3—f�Y _PI
-c3Y ) Commercial❑
}AQDRESS Type Const. Occupancy Sprinklered r
L✓�3 rib�— �lY� ❑Yes OM ❑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 Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 4NEW ❑ ALT. ❑ AD'N. D RPL. D MVE.
7. OF ❑ OTHER
WORK
El BLD. AQPLMB. ❑ MECH. ❑ M.H. POOL Certain of Exempt. Required Yes No❑ Number
or Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. l '�/( Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF PRIVATE 0 SEWER O Public❑Private❑
UTILITIES
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 provisio • •g y other state or local law regulating construction or the performance S�sc
of construction.SEE REVERS : 1i OR RE* IRED IN • CTIONS Plumbing
SIGNATURE OFAPPLICATION f
OWNER OR AGENT 1s DATE � (J ° Mech.
SPECIAL APPROVALS SPECIAL CONDITI o NS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE 2
Env.Health `� e..e...e
1430.1.5it• SEPA
Planning 1 li,6 Modular/
.6�b 4.4 MFG.Home d
Fire C
Prevent.
v
Engineer /x}64 Other(Specify) W
J
Li
Utilities
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
Budding // / IN 180 DAYS ��''�aa''"` _
Tech. '/ 2 /� DATEusZuFD1 5 8 4 PERMITI1¢.7 4 z * 5 8. 001.0 AL