1983, 11-28 Permit: 83B-2076 Mechanical Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER '
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY e)--- ---e> -
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEI.NO. ,
1. /yam
K) oc
, ` .c4- (..0 t L._v,'1�i` a R V _
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. ...__SE.-.S c-&<--- .P-beaYY\,I 2c:.--e_ 2 -t7 t c.. a. - -,
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
• l QG Ck• Cts_;l<.:3 C.A. >~ CAC(Zna North 'South [East I West ,
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
C�.ay'y Commercial CI4. ADDRESS ZIP Type Const. Occupancy Sprinklered
ctY`tifr ❑Yes ❑No ❑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.
1/
No.Baths No.Floors No.Fin.Rooms —No.Dwellings
TYPE ❑ NEW ;�'ALT. ❑❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK
0 BLD. 0 PLMB.I //MECH. ❑ M.H. El POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8• C .:%.iv t ,o iv ® l c._. —Co G A a Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLIC SEWAGE
Ownership FEES COLLECTED
9 UTILITIES PRIVATE D 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 witether specified herein • not. The granting of a permit does not presume to give au-
thority to violate or canc provisions of any • er ate o ocal law regulating construction or the performance
of construction.SEE RE - E SIDE FOR RE. . D INSPE IONS r Plumbing
SIGNATURE OF / APPLICATION 'f
OWNER OR AGENT' ' _./.44-1...ik • DATE dr ; Air= i Mech. -.CO
SPECIAL APPROVAL- SPECIAL CONDITIONS: (S REVERSE SIDE FOR NOTICE)
PRELIM. FINAL a ATE 1 Plan Check
Env.Health lam'1 oc)c) �5-f c.,. �Zry,At._E
ACI C/C C --" -rt..).-CtJ. :...i "TES i-li=o'cT -& SEPA
Planning
( 't• Modular/
Fire t C)i- 1 7,pc N(1 MFG.Home
Prevent. d
O
Engineer
Other(Specify) v
W
J_
Utilities ._,,{ ` ,�
TOTAL ,_c
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
E781R1' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �, U IN 180 DAYS
Tech. �y.�� f DATE ISSJUiD—2 8 -8 3 PERMIT N. 0 7 6 z * 2 4 0 Wp