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1983, 12-14 Permit: 83B-2526 Plumbing Fixtures
PLAN NUMlstn MrrLIt+R I ICFIV/ F'LKIVII I 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 1. LOT 2. BLOCK 1/ 1/2_ SUBDIVISION 3 OWNER tit 0 PHONE PHONE PARCEL NO. LEGAL DESCRIPTION: MAILING ADDRESS ZIP C�O ITRACTOR 4. God Sze K�G(Adi��r ADDRESS J394C, 3 E F©.c� 7 -51 -- DESIGNER 5. LICENSE EXPIRES Y-�3-S'y PHONE j-254 3 ya.3 Actual Set Backs in Feet to: North [South I East I West Size of Parcel Zone Classification Residential ❑ Commercial ❑ PHONE Type Const. Occupancy New Const. Valuation Sprinklered ❑Yes ENo ❑Req'd. Remode ed Valuation Total Bldg. Floor Area ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM 6. TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement TYPE In -NEW ❑ ALT. ❑ AD' N. ❑ RPL. E MVE. 7. OF WORK ❑ BLD. E YLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yes❑ No❑ Number 8.DESCRIBE WORK 'O 14)<_ Shorelines/Flood Hazard Yes❑ Not Applic. ❑ Plans Required ❑ Received E VALUATION 9. SOURCE F UTILITIES GAS ELECTRIC WATER PUBLIC ❑ PRIVATE E SEWAGE SEPTIC ❑ SEWER ❑ Ownership 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 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 OR REQUIRED INSPECTIONS SIGNATURE OF APPLICATIOya ^ OWNER OR AGENT DATE ll SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 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) TOTAL $ .sem PE RMITNUMBER 6'33 - FILE COPY WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATEI ED1 Qr — 8 5 PERMIT1& 2. 6 5 *4 5. 0 01DT*L