1983, 07-05 Permit: 83A-6099 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY �3� ' 427
(--...) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDR SS PARCEL NO.
1. - /3 6'54' 3
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER � PHONE PHONE
3. --14
er
MAILING ADDRESS ZIP Actual Set Backs In Feet to:
North 'South East I West
CONTRACTORCONTRACTORLICE1sISE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. 040 S 2,4 c.—ifeer pits x lo.c,10.-1- .23-Er Y -72y-3Y a _ Commercial❑
ADDRESS ZIP Type Const. Occupancy Spri
❑Yes ❑nklered No ❑Req'd. Q 3 * * 4 5.0 0
/�32cQ3 6 Fut,i v-5 d'• °•=.(C * 4 5,0 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
A * 0,00
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
609,8 0
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement p 7- 0 5-8 3
6. No.Baths No.Floors No.Fin.Rooms No.Dwellings -2 6 4 7 9,
TYPE XNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. CKPLMB. ❑ MECH. ❑ M.H. ❑ POOL avariaofce Exempt. Required Yes❑ No❑ Number
Received Yes❑ No CI
DESCRIE?.WORKShorelines/Flood Hazard Plans Required CI8. /Q 1 -/,,C7.cpr vI Yes❑ Not Applic.❑ Received El
VALUATION
SOURCE GAS ELECTRIC PUBLIC E WATER SEWIC ElPRIVATE❑ SEWER CIGE
FEES COLLECTED
9 LI
UTILITIES Public CI 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 pro ' 's of any other state or local law regulating construction or the performance `�
of construction.SEE REV .c,. DE FO.,REQUIRED INSPECTIONS Plumbing "T
SIGNATURE OF ( APPLICATION 7,,s,
OWNER OR AGENT DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check "I
PRELIM. FINAL DATE ,
Env.Health ' e
.. BSS,NS SEPA I
Planning / £ai(34_ Modular/
/ -re--5
MFG.Home d
Firere (! w £K c 1
Engineerrevet. /Cv 4( Other(Specify) J
G
/ QJ A4! `1
Utilities ✓
/ Ft) TOTAL $
SEPA
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 0,1 6 n n /�
Building ' IN 180 DAYS DATE ISSUED 5 —8 5 PERMIT N�. 9,9 z * 4 5 0 0 44AL
Tech. /��