1983, 06-15 Permit: 83A-5284 Plumbing Fixtures ' PLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY e3A "S '
C.--" NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES - ( 0 0
a
STREET ADDRESS s PARCEL NO. (L q 0 0 Y-
LOT BLOCK SUBDIVISIONr.i
2.
LEGAL DESCRIPTION:
t -
OWNER 112HONE PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North I South East `West r t; 7 'C
CONTRACTOR�/� .� . LICENSE EXPIRES
j SPHONE Size of Parcel Zone Classification Residential❑
" ,-Z--: �+a, ��(\a%.,..ks//.c 4/-/-r- 7 76-1. -3 y?/ Commercial❑
4. t .
ADDRESSZIP Type Const. Occupancy Sprinklered
/` ' c+�7�/ vl4.v1"{c t'/OLA) ae "It ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.FioorArea
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 EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK BLD. j PLMB. ❑ MECH. ❑ M.H. El POOL ❑ OTHER Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRIBE WORKorelines/Flood Hazard Plans Required❑
8• Co(, r.»I. P'(k // i x / .'-Cs Yes❑ Not Applic.❑ Received ❑
VALUATION SOOUFCE GAS LECTRIC WATE
PUICD SEPTIAC D 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
of construction.SEE REVERSE SID R REQUIRED INSPECTIONS Plumbing
SIGNATURE OF --- APPLICATION
OWNER OR AGENT �- ./(11-:----- /-- DATE e' -,s--- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE / Plan Check
Env.Health T:.7[—/ �f,_1-19 �"1`._�� --
Planning
`&-./S 4_ SEPA
Modular/
_
•-- ,1 t4`; 2— MFG.Home
Fire A t y d
Prevent. / / - C a�� S Other(Specify) C.)
Engineer 6 N E`.0`,'S 41�/ J
Utilities
_ 6-{-,0,/LA.-— / TOTAL $ —44_te
SEPA
I"•D —,/ / WHEN
/ WHEN MACHINE VALIDATED IN THIS SPACE,
Plans !"�ty‘fj tor-r PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED n �j 1 5
Tech.
) {° ( I N 180 DAYS DATE 141ED` 5 -U 3 PERMIT N2 8.4 5 * 4 9.U 0 a (-
TOTAL