1984, 02-15 Permit: 84A-1304 Plumbing Fixtures PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY eilA - (30-4
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS IL PARCEL NO.
,. Ti06, i = . 15 1-2
LO BOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3• &Oi• Nt ADDRESS IUB-L 612.8-0%3 MAILING ZIP Actual Set Backs In Feet to:
krrYV — North I South (East (West
CONTRACTOOR- }.��� /��y� LICENSE EXPIRES P�I N(�E ` Size of Parcel Zone Classification Residential❑
5t.).-re L til RA l'J 1 — 0133__ Commercial❑
4• ADDRESSType Const. Occupancy Sprinklered
�7� `,/� G,n Q
NI. 25 4 vY ti et- vy—1 • P ! A91 DYes ❑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 Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ;KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. PLMB. ❑ MECH. ❑ M.H. 1=1 POOL ❑ OTHER Certifi.of Exempt. Required Yes CI No Number
or Variance Received Yes El No
DESCRIBE WORK n�A � w� Q� Shorelines/Flood Hazard Plans Required❑
8. Z ' iit)(1 /� I�T/W CfAi YesD Not Applic.D Received ❑
VALUATION SODURCE GAS ELECTRIC PUBLIEO SEWIAC❑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 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 0.
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS c� Plumbing
SIGNATURE OF 72 APPLICATION -Z l a" 8 I
OWNER OR AGENT , DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health 11
I -- ibltiCT"
SEPA
Planning
f Modular/
MFG.Home >-
Fire a_
Prevent.
�� LU
Engineer 11V _ Other(Specify) W
—J
�f/� W
Utilities 26.O�
TOTAL $ (�C/
SEPA
WPlans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMIT.EN MACHINE TED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS ((l1 " 1
Tech. DATEc JED1 5 - 8 4
/� PERMITW& Q.4 5 *2 U. 0 0 flyTAL