1983, 09-08 Permit: 83A-8757 Plumbing Fixtures PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY e)3 -07C-2
CNORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
T: OMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES •
APPLICAN C
STREET ADDRESS Co�F., n PARCEL NO.
1. //
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. cr-
i• t.,
OWNER PHONE PHONE
3. Kc./",'ei r-<f,-,,G-,i• jy - �� ti
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
, // /1 /?L h j�<'crer"` North 'South [East I West is _ U _ �%
CONTRACTOR �� LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ - 6 4 7 e,
4. (%/fe"!7 f' ✓' 7/ 7< f .,-k--.'. o'/3- Commercial❑
ADDRESS / �( ZIP Type Const. Occupancy Sprinklered
,/ -/.;7 :/i` - /- G, i'1G37 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 Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE &NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. .IRPLMB. ❑ MECH. ❑ M.H. ❑ POOL orVariance empt. Required Yes❑ NoD Number
Received Yes❑ No❑
DESCRIBE WORK //✓�,<.),--c/ Shorelines/Flood Hazard Plans Required❑
/
8. �/ L ' , c Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE / GAS 1 ELECTRIC WATER
O SEPTICE E wnership FEES COLLECTED
9. LI
UTILITIES PUBPRIVATE❑ 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 SIDE FOR REQUIRED INSPECTIONS Plumbing fr/, +/c 0
SIGNATURE OF �'i APPLICATION�//
OWNER OR AGENT y• �� %� DATE �- Mech.
SPECIAL APPROVALS SPECIAL'C•NDITIONS:(SEE REVERSE SIDE FOR NOTICE)
Plan Check
P>;ELIM. FINAL DATE f
Env.Health /. Ai / f i'4 ?�f/ v
✓ SEPA
Planning / - t/. ;3.
. /L/&. 7- Modular/
`^ MFG.Home
Fire /.i cje e d
Prevent. 7) /4,-
y.. /4 a c: /40-1,,i' C-, e
Engineer /-�5 Other(Specify) LU
W
Utilities /- (,L4,;r,)/I'//P ,/7
LL
TOTAL $1'" 47et�
SEPA
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 OJ
Building IN 180 DAYS nll 9- 8 — 8 8 7 'S, z *61.
Tech. 9)-'Cir/e5"
DATE ISSUED PERMIT NO. TOTAL