1983, 03-16 Permit: 83A-1928 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT . PERMIT NUMBER
0} SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. lil! ,,,-1151
LOT BLOC SUBDIVISION LEGAL DESCRIPTION:
2.
OWNEF // CC,, PHONE PHONE
%L C„���\�7�
3 MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North I South I East I West --
CONTRA�TrfOR �,/ �� � � - LICENSE EXPIRES PONE+ �I Size of Parcel Zone Classification Residential
4 w/�vl v `N 9-- Commercial❑ I
A RESS P Type Const. Occupancy Sprinklered
-, 5G' 3 d ,c” G DYes 0N ❑Req'd. 1
DESIGNER "\ PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area -
-•....i •
�r ,•;
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 ❑ AST. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. PLMB. E MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes No
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. I �� F t�. -- Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC❑ SEPTIC❑
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 REVERS SIDE FOR REQUIRED INSPECTIONS Plumbing
/
SIGNATURE OF
---6.--(2_, /, APPLICATION 3 6 _8 3
OWNER OR AGENT DATE ! Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATEI^I �� I Plan Check
Env.Health ' I �i I .1 .("�'
3. . vt'qv i,I y� SEPA
"`
Planning - i I �i� 't✓f'� Modular/
(J MFG.Home )-
FireA ' d
Prevent. I C/ ] 'V!� 0
Engineer I l Other(Specify) W
Utilities
W.1 i41 . iml
l rL TOTAL $
SEPA f
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 o O
Building -�/ IN 180 DAYS -1 6 — 3 1 in .., 8 z * 5 7. a
Tech. �: . �Y.(a DATE ISSUED PERMIT NO. TOTAL