1983, 09-20 Permit: 83A-9231 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 0,3+1- q2.-3 (
ei NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. " _'
1. =E .i 0`7'Z(- --(1"
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. C--)964..a_C--)964..a_ VAlca...A a•vttiS G'3(-L'�G:C( -
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
tl(71-a_ A ece'{ North 'South East l West L. ~. . ,l
'CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ 6 7 `
4. C_,v+tiitc,t I., t�xu-er t7t. C: .4-4. -444 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
2.22. t` C:2-2- etCtz_C( ❑Yes ❑No ❑Req'd.
i
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.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW E ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 ❑ OTHER
WORK ❑ BLD. CIPLMB. ❑ MECH. ❑ M.H. E POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes Non
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8• Yes❑ Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC WAPUBTER
O SEPTIC SEWAGE Ownership FEES COLLECTED
9 F
UTILITIES 0
PRIVATE❑ SEWER 0 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 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
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing 1'1.0
SIGNATURE OF / APPLICA ION
OWNER OR AGENT __,,-----_--407--e -✓��*" DATE 7- Mech.
SPECIAL APPROVALS ' SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
I TC•c._C---r( SEPA
Planning
t c' , c. L Modular/
MFG.Home >-
Fire
a
Prevent.
O
Engineer
Other(Specify) V
W
J_
Utilities LL
TOTAL $ t—1 '°C
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building � tibe, IN 180 DAYS C n p 9 3.1 * 17.0 0 a H
(/C DATE 1�517ED 2 - U 5 PERMIT NO. TOTAL