1984, 04-02 Permit: 84A-2819 Plumbing Fixtures PLAN NUMBER APPLICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 51A - 'O l ci
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. s -3 7 / 2- CU iii 6fM,tir-`r-'
LOT BLOCK SUBDIVASION LEGAL DESCRIPTION:
2. 3 1-10 pt 0 t._-?e 0 lio 5-114
OWNER PHONE PHONE
3. A 4 l tsl. t_/: T- Vi t.,-/,11 S-3.1"--I 7 ? i
MAILfING ADDRE1S S ZIP Actual Set Backs in Feet to:
.1".'f! 0/) X // kUG 4s ( Q "A// North 'South East I West
CO RACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. Y '/'4 1 17L- ) INI A3fh► , Ji4/i g's 7 7 Z- 3 Js+Z Commercial 0
ADDRESS ZIP Type Const. Occupancy Sprinklered
7 b'V f\J t/rl4 5 1 tvf)A a .3 3/ V ❑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 1, f
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 ❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
7. OF
❑ OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No El
DESCRIBE WORKi,,I � Shorelines/Flood Hazard Plans Required❑
i4
8. Yes Not Applic.0 Received 0
VALUATION SOOURCE GAS ELECTRIC pWATERUBLIC❑ SEPTIC G❑ Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ 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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance /',/
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing t
SIGNATURE OFOWNER O OR JL`,) )/V)MLA- DATEAPPLICATION / Py Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) L
PRELIM. FINAL DATE *�
Plan Check
Env.Health ✓ l(, v- - /- 0/w
3- C M VSEPA
Planning f - 0/ Sp'I!S�4z. Modular/
Fire I r v / MFG.Home >
/
Prevent. ( - s/ w,vw O
Engineer f — /N 4-$> - Other(Specify) W
—J
Utilities I- . C 4✓(41) ti —e 4"„i
7�/ t r` 'y TOTAL $ `
SEPA I- le i r $/)v le;
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
Buildingp..9 // IN 180 DAYS //l�
Tech. DATSll1EC 2 -8 Q. PERMI 2NE.1, 9 z * OTOTAL