1983, 03-24 Permit: 83A-2199 Plumbing FixturesNNUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARb TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
s. v..,.". A4 0+'-, c_a
MAILING ADDRESS
CONT ACTOR
A o ed -o S£4t_ kre- pf v
ADDRESS
/ -1
ticss,1_
PHONE
PHONE
PHONE
New Const. Valuation
ZIP
Total Bldg. Floor Area
5.
LICENSE EXPIRES
PHONE
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
Building
Z�r1eZle.
North South East I West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req 'd.
9
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
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-
ADDRESS
yl 9210
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
�✓ L
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
Planning
MFG. Home
Fire
Prevent.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
t (u/jaN4't
TYPE SEW ❑ ALT. ❑ AD' N. ❑ RPL.
❑ MVE.
7.
OF
❑ OTHER
❑ BLD. <PLMB. ❑ MECH. ❑ M.H.
❑ POOL
Certifi. of Exempt.
Required Yes El No❑
Number
WORK
or Variance
Received Yes El No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
❑
8•
1-
9 F/X77X is
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC(
SEWAGE
SEPTIC
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 specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the pro . . ns of any other state or local law regulating construction or the performance
yl 9210
of construction. SEE REVE IDE F R REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT - DATE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
�✓ L
Env. Health
f '5
a 13,43 V$
SEPA
Modular/
Planning
MFG. Home
Fire
Prevent.
t (u/jaN4't
Other (Specify)
Engineer
Utilities
plansPERMIT IS NONTRANSFERABLE
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
PERMIT NUMBER
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. n n
DATERSSUEb2 4_ 8 3 PERMITNO.9, 9 z
�4100°�J_
TOTAL