1984, 02-02 Permit: 84A-926 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT P,EIR"�'IT NUMBER
V, SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY GI
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS f PARCEL''NO.
1. 8O5 aCLvc ERd .
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER,^ p A 1 PI�QMf� (w/� PHONE
3. 12.0
MAILING Y �R /'�/�� //`� `�C / � /,n/� Actual Set Backs in Feet to:
at y` 10° El cnQe North 'South East I West
CONTRACT / LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. 1{� Commercial❑
ADDRESS V ZIP Type Conat. Occupancy Sprinklered
❑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.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE gr..4deW 0 ALT. AD'N. O RPL. El MVE.
WORK L�.8'CU. r�""B. E MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No El
DESCRIBE WORK• �J/ / �/, Shorelines/Flood Hazard Plans Required❑
8• / /!�//� � Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATERPUBLIC SEWAGE
SEPTIC E Ownership FEES COLLECTED
9 UTILITIES PRIVATE CISEWER❑ 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 with whether specified herein or not.The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance 7-9�a
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF '��- 7- APPLICATIO
OWNER OR AGENT / 'ems �� /� DATE " 8<7 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health 4' 45i./eh*
-4Q41O ��t/( SEPA
Planning - /� UN (�
/\ Modular/
Fire / W ,4eiti MFG.Home >•••
Prevent. I C
Engineer —, Other(Specify) V
W
Utilities j„ ,t 5f// �� LL
SEPA - „ 1s TOTAL $ ‘7 '
'
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS ..�II ., 11 Q d 1 f o
Tech. n ,/,,Z/ DATEYS EU 4 PERMIT NO.2.6 2 * 7 y' U 0 ;OITAL