1983, 08-16 Permit: 83A-7841 Plumbing FixturesPLAN NUMBER APPL ICAT ION /PERMIT PERMIT rJUMBER
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 ADDRESSPARCEL NO.
1. // 7/ 7 e! . .2S 7�
LOT I BLOCK JE
2.
OWNER//"
3. )9s4dO
MAILING ADDRESS
NTRACTOR
4. ADDRESS
,L_-'Z2o_3 f:=
DESIGNER
J. ADDRESS
CHANGE OF USE FROM
6.
0f44)R! A
TO
PHONE
ZIP
LICENSE EXPIRES PHONJE
ZIP
North
Size of Para
Type Const.
PHONE NewOonst
ZIP 0 Main Floor
TYPE ANEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF El OTHER
❑ BLD. 12 LMB. 11MECH. ❑ M.H. El POOL
South I East I West
cone c;iassitication Residential ❑
Commercial ❑
Occupancy Sprinklered
Dyes ❑No ❑Req'd.
n Remodeled Valuation I Total Bldg. Floor Area
Upper Floors I Garage/ Storage I Greenhouse
Cover Deck Uncv. Deck Fin. Basement Unfin. Baser
No. Baths No. Floors No. Fin. Rooms No. Dwellings
Certifi. of Exempt. Required Yes No❑ Number
WORK
or Variance
Received
Yes❑ No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
WATER
PUBLIC r-1SEPTIC
SEWAGE
❑
Ownership
FEES COLLECTED
9• UTILLIITIES PRIVATE ❑ 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
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 REVEM SI REQUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health 2 WL'
g'n��s
Planning
Fire 1 Sv 4't
Prevent. �� K
Engineer �o4 eA
Utilities �tt-)14
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. 1 /
i
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
7
TOTAL $
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
DATEUluU l 6
0 45.00
*!+5,00
A *C.C'r u
/ (_` 4- C
6.479
PERMAU 41 z * 4 5.O O 110irAL