1983, 02-16 Permit: 83A-1133 Plumbing FixturesPLAN NUMBER — APPLICATION/PERMIT
/ SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99280 / (509) 958-3575
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS FNO.OT BLOCK SUBDIVISION IPTION:2.OWNER ,( PHONEPHONE
3.MAILING�ORE55``ZIP Feel lC:/� 2ULor17Ua 1, Souln EAnITS,�Ilnkl.�
CONTRACTOR - LIOENSEEXPIREe PHONE zone❑TI r-5 I o -fr 1- 050
4. ADDRESS 21P QxulvrlCY e'zr a, 9 2! oresONo oRxI
DESIGNER PHONE New Gorat%vxdlon RemWeIe]VaIiebon sI kTotalBldg. Hoor Arm
5.
ADDRESS ZIP Mein Floor UPW Floors Gvepel SlCrage Greenhouse
FERMIT NUMBER
- 1133
CHANGE OF USE FROM
TO
CorerOA�U.FIn.
Basement Untin. Beaement
6.TYPEIEW
No'moNo.
Fm. Rwma
No, OAelnnge
❑ALT ❑ AD' N. ❑RPL. ❑ MVE.
7. D OTHER
a/
WORK D BLD. PLMB. O MECH. 0 M.H. 0 POOL
CMin al ExMPL
Repujred
Yes❑ Noo
Number
Va .
As emd
Yes0 NCL]
DESCRIBEWOPK
SMrellrealFlcW Hazard
,xPj H
ShorYes
pare Re9.
N c. ❑
N.J.lved 0
VALUATION
SO RCE
OF
GAS
ELECTRIC
WATER
PUBLIC o
SEWAGE
SEPTIC ❑
0.HgrydP
FEES COLLECTED
9
UTILITIES
PRI INTED
SEWERD
C Privets
1 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 antl ordinances governing this type of
work will be complied with wh ,her specjfjed herei�ylr' not. The granting of a permit does not presume to give au-
Building
thority to violate or cancel t provisions of any of (er state or local law regulating construction or the performance
iyp�
of construction. SEE REV S1DE FOR REOUI ED INSPEC ONS
Plumbing .f�/
SIGNATURE OFAPPLICATION
OWNER OR AGENT T DATE [ J
Man.
SPECIAL APPROVALS
SPECI#L CONDITIO : (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Chad,
Env. Hreth
/ , ,
Y
SEPA
Planning
L T WA
r"
Mdula,
o
MFG. Mae
Fre
( r�p l
z
Re+enl.
L
En9inar
[
L Il-/ $ ��e: $/T.S
OIMr(SWIN)
L
Y
Uljlilln
/ Slfow�r
��
L`7
L
TOTAL S
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
para
PERMIT IS NONTRANSFERABLE
TH IS BECOM ES A PERMIT.
Exam.41
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tab
'L
IN 180 DAYS
Qo�, l 6- 8 3 3.3 z
O
* 2 9.0 0
ae.,