1983, 06-29 Permit: 83A-5969 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
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
STREETADDRESS PARCEL N0.
i . /�'eD 8 C .� 5` �
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNyR' PHONE PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North South East West
CONTRACTOR LICENSE EXPIRESy Size of Parcel Zone Classification Residential ❑
4.
O f e4� ZZ° 9��'� " �{ �3� BY G� Z ' Commercial ❑
ADDRESS ZIPp Type Const. Occupancy Sprinklered
13:L—)7- El Yes ❑No ❑Req'd.
DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
6. CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unf in. Basement
TYPE ANEW ❑ALT. ❑ AD'N. El RPL. 11 MVE. No. Baths No. Floors No. Fin. Rooms No. Dwellings
OF
% WORK El BLD. PLM B. 11MECH. ElM.H. ❑ POOL El OTHER Certifi. of Exempt. Required Yes El No[] Number
or Variance Received Yes[-] No El
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
8• r6<74 -Ac 1S Yes Not Applic.❑ Received ❑
VALUATION I SOOUFCE GAS ELECTRIC PUBLIC ❑ SEPTISEWAGE C ElOwnership FEES COLLECTED
9• UTILITIES PRIVATE 11 SEWER ❑ Public ❑ Private ❑
1 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 provi ' �qny other state or local law regulating construction or the performance
of construction. SEE REVERSESMIt FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF ) APPLICATION
OWNER OR AGENT DATE �f Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health UJe
SEPA
Planning C ` u� Modular/
Fire J MFG. Home
Prevent.
Engineerj, Other (Specify)
0460
Utilities �t Wf 0
I I 1 I 11-0
SEP—�
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuildingIN 180 DAYS
Tech. i, s5
PERMIT NUMBER
r
03* *45:00
*45,0010
A *0,00 00
596,82
06-29-83
z 6.417 9,
s�
cc�
TOTAL $ �J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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5, O O DATE IISSEDPERMITNO V' n z f0+AL
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