1983, 05-10 Permit: 83A-3858 Plumbing Fixtures PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 'E-511., `-
(,) NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. <`� eR/ T /S�—'� ,:) ,
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER` j PHONE PHONE ,
3. �I l3✓'o S c at,.s
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
i
_ North !South East I West ., __, .
CONTRACTOR`� ; E t r ��I1( / LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. �//���i b / _ •y-/.5--- 'y(S-5'3V j/ Commercial❑
ADDRESS �� Xyl&i/0� ZIP 5 2O Type Const. Occupancy Sprinklered
tea ❑Yes ❑No ❑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 Unfin.Basement
6.
TYPENo.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF KNEW, ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE. ❑ OTHER
WORK BLD. (PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
J or Variance Received Yes No
Required 0
8. DESCRIBE WORK�� �/G /G l�/j4L [//{fin�j�/LtEIW Shorelines/Flood t Pazaric.❑d Plans Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLICO SEPTICGO Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ SEWER❑ Public❑Private 0
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
of construction.SEE REVERSE SIDE FOR REQUIRED INSP ION -- Plumbing 3(O.e'
SIGNATURE OF ./
cC APPLICATION
OWNER OR AGENZ / ./ DATE �/�S Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health /—.X —3 _54 cue/FS,_/
Planning —�—(y ,o SEPA
/ w / /--,� /�,'/ / Modular/
Fire t _ MFG.Home
Prevent. /k—� JJ / ' a,
_ Jam— O
Engineer / —/ / / I X 7 ✓C S Other(Specify) V
c3 W
-I
Utilities A R vs -3
SEPA TOTAL $ �� '�
ht. w.7- /
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
Tech. p-)
5 IN 180 DAYS 05 -10 -83 385.8z * 56.00 ° ��® DATE ISSUED PERMIT NO. TOTAL