1983, 06-01 Permit: 83A-4674 Sink PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 0-* — 471—
C
NORTH 811 JEFFERSON /SPOKANE,WASHJNGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. �• I 1 i' 'z' 7-1'
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OW EF LL ++ �� ktekiPHONE tJ� PHONE
3 M ILIN DDRESSvI �H. �II�� - l ZIP Actual Set Backs in Feet to:
rte• l I 17 (p- C... North 'South East I West
CONTRAC-OR LICENSE EXPIRES ze of Parcel Zone Classification Residential❑
Aa,, COKi.S 1 r �✓e/f R�r -2-41 .--Si
Commercial❑
4. ADDRESS /�11 ZI Type Const. Occupancy Sprinklered
• 9 I f5 7 `- ,,zo' ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
* r' l0Y
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse „ '1
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement Li t., 7 I
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings ,.% 6- L i - 2 x
TYPE NEW ❑ T. ❑ AD'N. ❑ RPL. ❑ MVE. k`
ti /
7. OF ❑ OTHER f: ..
WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRI�E WO p� Shorelines/Flood Hazard Plans Required❑
8.
17;
8. Yes❑ Not Applic.17 Plans
❑
+VALUATION rI)c. 1ti
SOURCE GAS ELECTRIC WATERPUBLIC SEWAGE
SEPTIC O 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
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 q 00
of construction.SEE REVERSE DE FOR R. IR D INSPECTIONS Plumbing f/'
SIGNATURE OF / 211111711117" APPLICATION , ,
OWNER OR AGENT _M _k,-- DATE �1, J,� l/ f( P1.,) Mech.
SPECIAL APPROVALS SPECIAL CONDITIO ' : (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health I k rr' kF`, ,
SEPA 4
Planning
Modular/ v
MFG.Home )-•Fire
a
Prevent.
O
Engineer
Other(Specify) C.)
JrW
Utilities Cqe 0 J
E.
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED THIS BECOMES A PERMIT. 4 6 7' 4 z *9. 0 0 n C
Bah ing .' IN 180 DAYS 0 0 " 0 1 _ 3
DATE ISSUED PERMIT NO. TOTAL