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1984, 03-23 Permit: 84A-2533 Plumbing Fixtures
PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 4'A— 2.5 j- NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS —� c,t3 q . G�,y t. i PARCEL NO. LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. 3. tom, O 6,/01 Zy PHONE PHONE MAILING ADDRESS ZIP Actual Set Backs in Feet to: j North 'South East I West c�aTRACTO9 LIIC/ENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ 4. C.�0 ,5 `— �u'+/�fE-*!'dem/tit 7 �`C�( �R 3y�J Commercial❑ ADDRrc .2©� Z4+1 Type 4+1Type Const. Occupancy Sprinklered ❑Yes ❑No OReq'd. DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area J. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement 6. No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE ; NES/ ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7 WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No El Number or Variance Received Yes No❑ DESCRIBE WORK // Shorelines/Flood Hazard Plans Required 0 8. U°P16( Yes❑ Not Applic.❑ Received 0 VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED9 UOLITIES PRIVATE 0 I SEWER El Public 0 Private 0 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 grantingof apermit does notpresume to Building P P give au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.SEE REVERSES E F UIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION / OWNER OR AGENT DATE �al Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Plan Check PRELIM. FINAL DATE Env.Health 2410 SEPA Planning I S pod - Modular/ Modular/ Fire r rj' MFG.Home Prevent. t S c� d r.G-4SO4 o Engineer Other(Specify) v F W J Utilities LL �� 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 q Building 3/Z 2 I N 180 DAYS DATE ISSUED —U 4 PERMIT NO./ z * 0 O TOTAL / 7