1984, 03-13 Permit: 84A-2151 Plumbing Fixtures PLAN NUMBER APPLI CAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ¢A ";I 7
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1. STREET ADDRESS /� /3 r 6 'PARCEL NO.
LOT BLOCK SUBDIVISION _J LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3.
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North [South East I West
TRACTOR /� LICENSE EXPIRES PINE Size of Parcel Zone Classification Residential 0 I r. * ,Y " T
4. t 0� f4< /�[ '�� �'�c�- di o-� V `1�Y 3`4?3 Commercial❑
•
AA/DRESS t / Type Const. Occupancy Sprinklered ,
3�0 3 f Fo�*rS� #7O?l6 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
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 ,. NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
❑ OTHER
WORK ❑ BLD. JZLMB. ❑ MECH. ❑ M.H. ❑ POOL Certlfi.ofExempt. Required Yes❑ No❑ Number
or Variance Received Yes 0 No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8• /a f-'- Yes❑ Not Applic.❑ Received 0
VALUATION SOOURCE GAS ELECTRIC PUBLIC WATER SEPTICW ❑ 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
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 provi-'•• of any other state or local law regulating construction or the performance Ge
of construction.SEE REV'SE S •E FO- REQUIRED INSPECTIONS Plumbing
SIGNATURE OF �� APPLICATION3_ /3 .._q...t f
.
OWNER OR AGENT rr. DATE Mech.
SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health 3 co e
cy 4-51 t, SEPA
Planning ( tJ Q
( 5/V E Modular/
Fire Wri MFG.Home
Prevent. / w'5 I' 0
Engineer I, l'il E'• Other(Specify) W
66 J
Utilities du'5-4 G� LL.
TOTAL $ a
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. o
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED -' 2 1 5,1 z * 5 8. °-
t_..
Building IN 180 DAYS 0 3 -13'—8
Tech. cc7
37I
DATE ISSUED PERMIT NO. TOTAL