1983, 04-11 Permit: 83A-2788 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
el SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY �4 - ale'
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/ (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. L.• (4 50 Z l ITN
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. * c
OWNER PHONE PHONE * s T.
3. 1.A,'1/4)ITGO IN I'Vtt,V T r A r. ..
MAILING ADDRESS ZIP Actual Set Backs in Feet to: /
1✓ : 7+ Cvcc,:2 L\-r-\ Qct..-).4. North 'South East I West 2 7 V 7
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial❑ C.4— 1 1 - ':
4. ADDRESS ZIP Type Const. Occupancy Sprinklered L1 7 c,
❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area „1
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. Cl MVE.
7. OF —// ICIOTHER
WORK ❑ BLD. fIdPLMB. ❑ MECH. ❑ M.H. CI POOL Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes❑ No El
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. S F%)C-[cn.2c Yes Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLIC 17 SEWAGE
E Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ 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 same be true and correct. All provisions of laws and ordinances governing this type of Building
work will be complied with whe er specified herein or not. The • • :ng of a permit does not presume to give au-
thority to violate or cancel the •r ons of any .ther state • . ..--.w regulating construction or the performance
of construction.SEE - VE• •E •E'F'�R RE• IRE•_ N •NS Plumbing 'Z'S,oc)
SIGNATURE OF
OWNER OR AGEN WAIIITNli�!/� DATECATION Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE 1 .-r0%c-•cT Plan Check
Env.Health i C N S3
SEPA
Planning t �✓1/%.))‘..
1 K I ( 5,vv,� Modular/
Fire - MFG.Home ),
Prevent. 1 1-F..)._c> H-rn_ 0
Engineer Other(Specify) Ca
W
J
Utilities _ Li
TOTAL $ ��` -.)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 J IN 180 DAYS (� Q_ 7 6
07,_
Tech. 9n-4 //Ccs DATE ISSUED 1 - 8 PERMIT 8. 8 2 * 2 5. 0 U TTAL