1983, 03-24 Permit: 83A-2203 Plumbing FixturesPLAN NUMBER APPLICATION /PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 65A—x.203
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. //8/`j C a5�
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
VVVIV CII rA
4 /"/ osc-0
MAILING ADDRESS
4. -f` "J" .-c
ADDRESS
13oZ03 uC
DESIGNER
5.
ADDRESS
ZIP
LICENSE EXPIRES PHONE
PHONE
ZIP
North South East I West
Size of Parcel Zone Classification Residential❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation I Remodeled Valuation I Total Bldg. Floor Area
Main Floor I Upper Floors I Garage/ Storage I Greenhouse
s CHANGE OF USE FROM TO 11 Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
TYPE SLUEW El ALT. 1:1 AD'N. 11 RPL. El MVE.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
7. OF ❑ OTHER
WORK ❑ BLD. A P -LMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
or Variance
Required Yes El No❑
Received Yes ❑ No ❑
Number
DESCRIBE WORK G
9r /
Shorelines/ Flood Hazard
Yes❑ Not Applic. ❑
Plans Required EI8.
Received ❑
VALUATION
9
I SOURCE
OF
UTILITIES
GAS
ELECTRIC
I WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER E,
Ownership
public ❑Private ❑
FEES COLLECTED
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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERS IDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach•
SPECIAL APPROVALS
SPECIALCONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health u>G
Planning
Fire l l 6
Prevent.
Engineer
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building ---% a5 _ j_ IN 180 DAYS
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE(�4S�UE� — PERMI"6. 0'3 z
*41,00+&AL