1983, 12-14 Permit: 83B-2530 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
6 CHANGE OF USE FROM I TO I Cover Deck I Uncv. Deck I Fin. Basement I Unfin. Basement
No. Baths
APPLICANT: COMPLETE NUMBERED SPACES —
PRESS HARD TO MAKE 3 COPIES
No. Dwellings
STREET ADDRESS
PARCEL NO.
1.
7. ❑OTHER
/iy.2f c as -
LOT
BLOIVISION
CK
SUBD
❑ BLD. r-�PLMB. ❑ . ElMECH. M.H.POOL
LEGAL DESCRIPTION:
2.
Received Yes❑ No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
OWNER
PHONE
PHONE
3.
d
GAS
ELECTRIC
I WATER
PUBLIC ❑
I SEWAGE
SEPTIC ❑
Ownership
MAILING ADDRESS
FEES COLLECTED
ZIP
Actual Set Backs in Feet to:
PRIVATE ❑
SEWER ❑
North South East West
CTRACTOR
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential❑
4.
oL
h�^�3"Sr
912 `f_j 4�
OWNER OR AGENT DATE
Mach.
Commercial ElA
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
IDSESS-3—'��
4"k -a
Type Const.
Occupancy
Dyes Spr❑Nor� ❑Req'd.
Env. Health
�
-a
DESIGNER
l
(x/45 rt/
stem G
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
rdd11
MFG. Home
Fire
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6 CHANGE OF USE FROM I TO I Cover Deck I Uncv. Deck I Fin. Basement I Unfin. Basement
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
TOTAL $ T
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
PERMIT NUMBER
03 ✓ v��
DATE ISSZED 1 4— b 3 PERMIT41�. z * 4 5.O 0 l�t'AL
a
O
U
W
J
U_
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE IKNEW ❑ ALT. ❑ AD'N. ❑ RPL. ElMVE.
7. ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
❑ BLD. r-�PLMB. ❑ . ElMECH. M.H.POOL
WORK
W
or variance
Received Yes❑ No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.
Yes Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
I WATER
PUBLIC ❑
I SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9•
I UTILITIES
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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
�3
of construction. SEE REVERSE SID R ED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION 1,,1 �IK--Q 3
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
2 WG
Env. Health
l
(x/45 rt/
stem G
SEPA
Modular/
Planning
rdd11
MFG. Home
Fire
Prevent.
tr 4,&u,, S 1
Other (Specify)
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
TOTAL $ T
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
PERMIT NUMBER
03 ✓ v��
DATE ISSZED 1 4— b 3 PERMIT41�. z * 4 5.O 0 l�t'AL
a
O
U
W
J
U_