1983, 11-28 Permit: 83B-2072 Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ,_s , v�-2.....
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES – PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. '
1. l� .'_7 4—c4 t t
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. 'Sc.t_ !'v )4t LI-n iv r''la.G,-F
MAILING ADDRESS ZIP Actual Set Backs in Feet to: -,
C . -, ,j 4:7"1-1 C C{. North I South [East I West
CONTRACTOR i LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
1�7CS Y..-Tt.�w�rST `--ht, A/ L C24 -2. _x) Commercial❑
4. ADDRESS• 1 D 2,A+21 (a ZIP e,`� Type Const. Occupancy Sprinklered
�IVV "`_"t ❑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 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK
0 BLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL CeVaii ofExempt. Required Yes❑ No❑ Number
or Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. it ,(72x (.1•3 iv t c C>r4 i.c Cis.)Cc— Yes Not AppIIc.❑ Received ❑
� —
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. OF PRIVATE❑❑ SEWER 0 Public 0 Private 0 UTILITIES
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 -Mel the provisions o ny other s to or local law regulating construction or the performance
of construction.SEE ERSE SIDE FOR QUIRED PECTIO S Plumbing
APPLICATION 1
SIGNATURE OF DATE //� ,-J\ Mech. 1
OWNER OR AGENT '/141/1')-�� " r, ./4,%--- '
SPECIAL APPRO A SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINA DATE I i'
Env.Health i p f ` )
SEPA „:
a
Planning Modular/ •
MFG.Home )-
Fire
Prevent.
Engineer Other(Specify) W
J
LL
Utilities
TOTAL $ q%'-,.
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 11 p {{�� n n
Budding
i/ IN 180 DAYS DATEL.1.-.,
SSUED2 8 —8 PERMIT O'. 7. 2 az
* 18. 0 0$O AL