1984, 04-13 Permit: 84A-5322 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT bF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. Com, 14-- tAz. r��%iLitiF�
LOT
2.
BLOCK SUBDIVISION
OWNER
3 L 2`1 • 1'v4 fir. a
MAILING ADDRESS
N
\\5‘6t 1,t I'4 rc NtA._Lsc
CONTRACTOR
4. ( l.P+C ,
ADDRESS
C.
PHONE
LICENSE EXPIRES
PARCEL NO.
LEGAL DESCRIPTION:
PHONE
--161(6,
ZIP
CtCzz.{
PHONE
4 - 3N
Actual Set Backs in Feet to:
North [South
Size of Parcel
East
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
c-tG Ze)
PHONE
ZIP
TO
TYPE 4IEW EOFl ALT. CIALT. CIAD' N. ❑ RPL. C MVE.
7.WORK ❑ BLD. LMB. ❑ MECH. M.H. E POOL El OTHER
/
Type Const.
Occupancy
New Const. Valuation
West
Zone Classification
Residential F.
Commercial ❑
Spr'nklered
[-Wes CNo ❑Req'd.
Remode ed Valuation
Main Floor Upper Floors Garage/Storage
Total Bldg. Floor Area
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Required
Received
Fin. Basement
Greenhouse
No. Fin. Rooms
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS ELECTRIC
WATER
PUBLIC ❑
PRIVATE C
SEWAGE
SEPTIC C
SEWER C
Shorelines/Flood Hazard
Yes❑ NotApplic. ❑
Ownership
Public ❑ Private E
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-
`,hority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REV SIDE FOR REQ IRFD INSPECTIONS
SIGNATURE OF
OWNER OR AGEN
DPLICAT
DATE
SPECIAL APPROVAtCS
PRELIM. FIN
L DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
L_ W'aV
S. t
.6'tl4W(?'
0 14T-4—
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Yes❑ NoE
Yes❑ No❑
Unfin. Basement
No. Dwellings
Number
Plans Requ'red C
Received C
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
—7;3Z7.--
3
ZZ
3* *6600
*66.0M
f1 *C,00
3321 -2
04-13-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYSSUED1 3 - 8 4
PERMIT D. 2. 2
*66.00 W.dilAL