1983, 09-15 Permit: 83A-9071 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 0,k - 771
C.. NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 2 G /4 . g- �"h
COT . BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. .
OEJ3 - PHONE PHONE
3. 'q. /+Airs' ?-3'-a 7(,8'
AILIN ADDRESS rf._
ZIP Actual Set Backs in Feet to: -
E- l 7_O/4--- �9W.4J North ISouth East I West
ONTRACT LICENSE EXPIRES P ONE Size of Parcel Zone Classification Residential
4. 7.t �k Fev, y Is�s /7-31-0 5-%10 Commercial❑
AD�RESSD v ���� Zlp�2�/ Type Const. Occupancy SprinkleredN
LL77!!//f(//99_ AI GGl l� ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
J. ADDRESS ZIP Main Floor Upp73r Floors Garage/Storage Greenhouse l; * * J
* 21, 00
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6. FI, *
No.Baths No.Floors No.Fin.Rooms No.Dwellings r / ;, .
TYPE ❑ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE. % C 0
7 ,PLMB. ❑ MECH. ❑ M.H. CI POOL ❑ OTHER Certifi.ofExempt. Required Yes No❑ Number 0 y— 0 3
WORK ❑ BLD.
or Variance Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑ 6 C; 7
$. Yes❑ Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLICO SEPWTIC Ownership FEES COLLECTED
•
9 UTILITIES PRIVATE❑ SEWER❑ Public❑Private O
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 1) >/ o
`o
of construction.SEE REVERSE SID _ •.. OUIRED IN r TIONS Plumbing l(p V
SIGNATURE OF / l APPLICATION ,�JZ
OWNER OR AGENT DATE �� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health /— %Q F t/- 4
/ , ,(� ) �f SEPA
Planning --S/:: 1,e, ��/ 1
a Modular/
Fire i '–' V MFG.Home
Prevent. t3
/� �� / Q
Engineer
f f 1-417b t e-(i Other(Specify) co 0 v
Utilities i t)
TOTAL (f
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 COMMENCEDt
Building IN 180 DAYS 0 9 - 5 - 8 3 9 0 7, 1 'z * 2 1,0 0
Tech. St �'/' DATE ISSUED PERMIT NO. TOTAL