1983, 06-29 Permit: 83A-5967 Plumbing FixturesPLAN NUMBER APPL ICAT ION /PERMIT
or Variance
Received
FPSffMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANIf, WASHINGTON 99260 / (509) 456-3675
Shorelines/ Flood Hazard
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
Received ❑
FEES COLLECTED
1,20 ?5 C --257r—
PARCEL NO.
SOURCE
OF
Lor BLOCK SUBDIVISION
2.
LEGAL DESCRIPTION:
I WATER
PUBLIC El
PHONE PHONE
OWN R.45C 0
Ownership
3
UTILITIES
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
�C TRACTOR LIC NSE EXPIRES
o $t•4
PHONE
North South East West
Size of Parcel Zone Classification
c.v
4.
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
Commercial ❑
ADDRESS
Building
thority to violate or cancel the provisio of any other state or local law regulating construction or the performance
3.�.d3 /�— �G �/e �Sf
ZI
+�.21C
Type Const.
Occupancy
Sprinklered
c_-
OWNER OR AGENT DATE �- �3 --
Mach.
❑Yes ❑No ❑Req'd.
v X
'DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Plan Check
Env. Health
ADDRESS
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Planning
V
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
�e�SC.I
/ _J
PERMIT IS NONTRANSFERABLE
E�7�;.
TYPENo.
ANEW El ALT. ❑ AD'N. El RPL. El MVE.
!•
Baths
No. Floors
No. Fin. Rooms
No. Dwellings
OF
WORK El BLD. gi.CPLMB. ❑ MECH. ElM.H. El POOL E] OTHER
Certifi. of Exempt.
Required
Yes❑ No❑
Number
WHEN MACHINE VALIDATED IN
Y
CL
O
V
W
J
LL
or Variance
Received
Yes ❑ No❑
Plans Required ❑
DESCRIBE WORK
8 t
Shorelines/ Flood Hazard
Yes Not Applic. ❑
Received ❑
FEES COLLECTED
VALUATION
9
SOURCE
OF
GAS
ELECTRIC
I WATER
PUBLIC El
SEWAGE
SEPTIC ❑
Ownership
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
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 provisio of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SID FOR REOUIRED INSPECTIONS
Plumbing —
SIGNATURE OF APPLICATIO
OWNER OR AGENT DATE �- �3 --
Mach.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
� �G
Plan Check
Env. Health
r� �.4-9 v
SEPA
Planning
I
)
/ 5/to4L
l
Modular/
MFG. Home
Other (Specify)
Fire
Prevent.
Engineer
�e�SC.I
/ _J
PERMIT IS NONTRANSFERABLE
TOTAL $
Utilities
es
SEPA
Plans
WHEN MACHINE VALIDATED IN
THIS SPACE,
Exam.
THIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
W. I N 180 DAYS
L
06-29-83
' J
596,75 O *45,00a
Building
Tech.
DATE ISSUED PERMIT
NO. TO+AL
Y
CL
O
V
W
J
LL