1984, 01-10 Permit: 84A-235 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY MA — 2-!
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 . C.Cfl 4(:) 0+K ,
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION:
2. -j lr!al�tfN.t:_ Fa2V1T1 J0(
OWNER PHONE PHONE
3. A f (.1-4 A i'i ei'r1 a S34-o2 iq
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
• /_g 10 1°14 'GI 1 North (South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial❑ '
4• ADDRESS ZIP Type Const. Occupancy Sprinklered ,
❑Yes 0 N ❑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 Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE /NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OFElOTHER
WORK ❑ BLD. RIPLMB. ❑ MECH. ❑ M.H. El POOL CertiiiaoExempt. Required Yes❑ No❑ Number
or Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. DA-f4FC CI CPL JV Q U i Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE t?GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
PUBLIC D SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private 0
9. F
UTILLIITIES
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 r
60
of construction.SEE REVERSE S).pE FOR REQUIRED INSPECTIONS Plumbing / �'
SIGNATURE OF //�� APPLICATION ,
7_4_
y 3Mech.OWNER OR AGENT . I■ A.. DATEf
SPECIAL APPROVALS SPECI L CO 'ITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health I _ BAT 1 t -{—t� ( S� �� SEPA
Planning _ / nit''1/ V C7 — 4 i 00 Modular/J 'V MEG.Home >-
Firee �} 00 0
Prevent. I — I l/ ��� ,
c�
Other(Specify) NJ
Engineer J
1 7
LT
Qom.
y q�;_ iq Y�- �� TOTAL $
SEPA I 'FS- Rill lI p 0
•--- WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOD IF WORK HAS NOT COMMENCED
Building if 1 IN 180 DAYS ((�� 11 ,�1 O _ (
Tech. ' /( DATE1S9l1ED 4 PERMIT NCZ 3,5 0 * 17. 11 0 po1J`AL