1983, 12-14 Permit: 83B-2528 Plumbing FixturesPLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER
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. / / 7/g L . ,-2�-4
LOT
LEGAL DESCRIPTION:
2.
=UBDIVISION
OWNER
5� b
PHONE
PHONE
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East West
CONTRACTOR LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential F-1
4 Ceti �,Sf,gd/csF� •C�•,2J-8cy
'?A,/ ---T
7
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
/3,'2,::P_.-7uz 3r, f—
G
C 6 ';?
--Yes No DReq'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.
TYPE 4..4EW
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
f
E1 ALT. � AD' N. ❑RPL. El MVE.
7• OF ❑ OTHER
Certifi. of Exempt.
Required Yes El No[]
Number
WORK ❑ BLD. iN-RLMB. ❑ MECH. ❑ M. H. ❑ POOL
or Variance
Received Yes El NoF-
DESCRIBE WORKO
8• �l>C�
Shorelines/Flood Hazard
Plans Required ❑
Yes Not Applic. ❑
Received ❑
VALUATION I
SOOUFCE
GAS
ELECTRIC
WATEPUB IC EI
SEPT C L1 I SEWAGE
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 specifie herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provision of an other state or local law regulating construction or the performance
�J
of construction. SEE REVERSE SIDVFIDR REQ IRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION��Y
OWNER OR AGENT — DATE —__ _
Mach.
SPECIAL
APPROVALS
SPECIAL COND TIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
Plan Check
Env. Health
wc_
R�
SEPA
Planning
Modular/
v,
MFG. Home
>_
Fire
Prevent.
//CL
5'I�o '�
O
Engineer
S
Other (Specify)
W
u�
Utilities
L� C
J_
U_
cv L
TOTAL $
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
Building
Tech.
IN 180 DAYS
I j_ 1 z �j
4— 8 l Z" R z * 4 5' 0 0 0
DATE"D1 PERMIT4(