1983, 09-15 Permit: 83A-9069 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1."S`o 3G / B S ce.)006.[ v IF4
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3
Pit 5.5 �(Die s5
MAILING ADDRESS
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North I South East West
CONTRACTOR
Jtg S *c- If�N•f!.tc.v��
4.
ADDRESS
/3.2 0-2 0.L2sf/—
DESIGNER
LICENSE EXPIRES
Si- 23 '-err
PHONE
Size of Parcel Zone Classification
afc
Type Const.
Occupancy
Residential E
Commercial
Sprinklered
Yes ❑No ❑ Req 'd.
J. ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE EittsIEW E ALT. ❑ AD' N. E RPL. ❑ MVE.
7. OFM.H. ❑POOL ❑ OTHER
WORK ❑'
BLD LMB. ❑ MECH. E.
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage/Storage Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
No. Baths
No. Floors
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes ❑ No❑
Number
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
/off F's
GAS
ELECTRIC
WATER
PUBLIC E
PRIVATE ❑
SEWAGE
SEPTIC
SEWER
Shorelines/Flood Hazard
YesE Not Applic. E
Ownership
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
work will be complied with whether ified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the pr• isions • any other state or local law regulating construction or the performance
of construction. SEE REVER_ IDE FOR EQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE is
SPECIALC.NDITIONS: (SEE REVERSE SIDE FOR NOTICE)
3`‘-r
S. s.,5
t 7-"9
2 5 4A, cc c
sid
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required l
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
- 41°..TOTAL $
PERMIT NUMBER
U3*
*53.00
*53.00u
*0..00
90682
09-15-83
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9-15-83 906,92 *53,OOa'—
DATE ISSUED PERMIT NO. TOTAL