1983, 08-17 Permit: 83A-7894 Plumbing FixturesPLAN NUMBER
APPLIGAT._ _ IT
SPOKANE COUNTY - DEPAfTIVINT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
LOT
2.
OVINE
BLOCK SUBDIVISION
/7d
PARCEL NO.
R
3 h r �
/e�u 51 rain �;�.c•
(LING ADDRESS
AA .525- Ma, ,ar--
TRACTOR
4. r� r- rc5; 4 fRa. ado ;4/
prREve x D /
DESIGNER
5.
ADDRESS
(1,.
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North I South
LICENSE EXPIr
PHONE
534/-6225?
Size of Parcel
11 Zone Classification
East
West
Residential ❑
Commercial ❑
ZIP 7,
Type Const.
Occupancy
Sprinklered
❑Yes El No ❑ Req 'd.
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 7NEW
7. OF
WORK ❑ BLD.
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
APLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes El No❑
Received Yes No❑
Number
8.
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILITIES
f? r x4/ .1-e- ,/..5
ELECTRIC PUBLC WATER
PRIVATE ❑
GAS
Shorelines/Flood Hazard
Yes NotApplic. ❑
Plans Required 0
Received 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 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
work will be complied with wh
thority to violate or cancel th
of construction. SEE REVER
SIGNATURE OF
OWNER OR AGENT
r
prov'
ES
p: ified herein or not. The granting of a permit does not presume to give su-
ns of any oth-r state :r local law regulating construction or the performance
F • R REQ ' I INS • CTIONS
SPECIAL APPROV/lCLS
PRELIM. FINALt`_ ' TE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
(i4 z.
f _
/- P/'oi-
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
?3.
TOTAL $
PERMIT NUMBER
-785,-/
CII Grnov
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IFRED 17 - 8 3 PERMIT NOJ 9. 4 z
*7 3.0 Ol,4AL