1983, 05-05 Permit: 83A-3685 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
V SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
8311 6R&
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 6 B/47eo !r C7
LOT BLOCK SU DI lsloN LEGAL DESCRIPTION:
2.
OWNE.r•-•' e.----". PHONE PHONE
3 MAILINGA DRESS ` 1, c-i 9199/
Q7 ZIP Actual Set Backs in Feet to:
r#51%,?! �? 5 y �C'i �/�m North 'South [East I West
C CTOR ^_ I �� LICENSE EX IRES PHONE _ Size of Parcel Zone Classification " f
L/C I- ! T(/ I� 6 ��L' ,5, y: l Residential 0
4. / Commercial 0 + ,- 0 „
rF SS.0i e� ZIP Type Const. Occupancy Sprinklered
I(�C(��dp)) ❑Yes OW ❑Raga. J',
v '•
DESIGNER P ONE 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 '` u
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE KNEW ❑ ALT. El AD'N. ❑ RPL. CIMVE.
7. OF
WORK ❑ BLD. LMB. ❑ MECH. ❑ M.H. CI ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
8.
/-�,,DESCRIBE WORK ! Shorelines/Flood Hazard Plans Required 0
`y x 4Le--rr,S Yes❑ Not Applic.❑ Received 0 •
VALUATION • SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9. OF
PUBLIC 0 SEPTIC 0
FEES COLLECTED
UTILITIES PRIVATE❑ SEWER 0 Public 0 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
work will be complied with whether sp- ified herein or not. The granting of a permit does not presume to give au- Building
thority to violate or cancel the • o -•• s of any other state or local law regulating construction or the performance
of construction.SEE REVER SI' •R RE• _• IN'"ECTIONS Plumbing l0
SIGNATURE OF �� APPLICATION y�
OWNER OR AGENT _rim �1f DATE (7 /JZ c'� Mech.
SPECIAL APPROV • SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINA .ATE %✓t7rr' •
Plan Check
`
Env.Health !41
5`( 1/44/ ..6 / SEPA
/
Planning �ytv
Modular/
Fire 5 MFG.Home
Prevent. ./.` a
Engineer '���" 0
�/ Other(Specify) c.7
Utilities / -61J
/
it
- - a`,34400.54-e• TOTAL $
SEPA
Y/ 7'1 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
Tech Ing
IN 180 DAYS L55
DATE,EDO - PERMIT N6. 8. 5.z * 0 0 TOTAL