1983, 08-29 Permit: 83A-8301 Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 83P _ .e .(
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
C.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. G Q * * 1 .'. 0 0
1. f.. 4406g Tr1 .
LOT BLOCK SUBDIVISION LE AL DESCRIPTION: * 1 0 0_'
2. - A x r 2
OWNER PHONE PHONE
3. Nbwlekc� , k>A42‘t..) +Sererca. 8 3 0, 0
MAILING`ADDRESS ZIP Actual Set Backs in Feet to:
E �►
- 13 ` H q4) . North (South [East I West 0 F4)— 2 y-P l
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ 2 6 4 7 9.
4. St;r`A-E Commercial 0
ADDRESS ZIP Type Const. Occupancy Sprinklered
. 'fl Mt: ❑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 Unfin.Basement
6.
TYPE C] NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF � ❑ OTHER _
WORK ❑ BLD. ❑ PLMB. IB'MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes❑ No❑
DESCRIBE,144.0QK Shorelines/Flood Hazard Plans Required❑
8. (IS -4),Pt t'3(j Yes Not Applic.0 Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC❑ SEPTIC❑
PRIVATE 0 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 sa to be true and correct. All provisions of laws and ordinances governing this type of Building
work will be complied with w then specified herein . not. The granting of a permit does not presume to give au-
thority to violate or cancel t e rovisions of . y oth: state or local law regulating construction or the performance ,
of construction.SEE REV S SIDE FOR 7• IR D INSPECTIONSPlumbing
SIGNATURE OF / / A. APPLICATION G _ Mech. 12.00//k.
OWNER OR AGENT '`y"" DATE C
' SPECIAL APPROVA S SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health 26 of i " —?,?,..c,,
�/
SEPA
Planning 6` A y2-.,
Modular/
MFG.Home d
Fire
Prevent.
O
Other(Specify) v
Engineer LU
J_
Utilities W
TOTAL $ 1).. r
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
o
Building IN 180 DAYS o * 1 2.0 0 tL I"
Q
S301z
Tech. C� / DATE Tip.2 9 "0 3 PERMIT No. . TOTAL