1983, 10-26 Permit: 83B-919 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 17
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 6 `' ,-
01 NORTH 811 JEFFERSON /SPOKANE,WASHIImGTON 99260/ (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER 1,152.:NE PHONE
Ki fiL.�'�cfg•K -,�Ion
3.
MAIL!NG DDRESS /�r Actual Set Backs in Feet to:
[. I 6'r/Lik' rtU_ . % '92,e Co North !South East (West
4 C NT+ TOq rL��i3i Ni /LICENSE EXPIRES P - s��I Size of Parcel Zone Classification Residential 0
�}N R `JI C/� Commercial❑
ADDRESS ZIP • Type Const. Occupancy Sprinklered
«,f fes., PAN ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Fioor Area
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
I, `'
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 gr-NEW
/NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. / ,` 7
7. OF ❑ OTHER
WORK ❑ BLD. J/PLMB. ❑ MECH. ❑ M.H. ❑ POOL oCrVarianExempt. Required Yes No❑ Number
Received Yes LI No
8 DESCRIBEWORK �Il4/`�� Shorelines/Flood Hazard Plans Required
Iflf Yes❑ Not Applic.❑ Received ❑ t
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
PUBLIC❑ SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private❑
9• UTILITIESLI
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 4,
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing //
SIGNATURE OFAPPLICATION ''
OWNER OR AGENT DATE �� _-.�(� � Mech. t
f
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Plan Check
PRELIM. FINAL DATE N - I IfV' I c4
Env.Health y 1 v �1�K
�
i�7 SEPA
Planning I -4, 6/2-- I/r Modular/
MFG.Home ,�.
Fire fes, a
Prevent. r/ V
Engineer I }
K, 1/ I Other(Specify) W
'I �� J
Utilities
►Jp► r CNKLL
,/ TOTAL $
it_ "
SEPA IAN'. ,`I� WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 10/� IN180DAYS 10 =26 -83 1,9z * 49,00 ° _
Tech. ((E / DATE ISSUED PERMIT IC,. ilOAFAL