1983, 06-29 Permit: 83A-5965 Plumbing FixturesPLAN NUMBER APPLIICA.TIO.N/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
\1/ APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
PARCEL NO.
ff 7l/ 5),-t
No. Dwellings
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
I
Required Yes No❑
OWNER�/
PHONE
PHONE
/tet �.SC f0
Received Yes No❑
DESCRIBE WORK
3.
Plans Required ❑
8.�— /X tJ� 7
Yes Ll Not Applic. ❑
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
GAS
ELECTRIC
North South East West
CO TRACTOR^C
NSEE EXPIRES
:LlIt_12j.-g
PHONE
Size of Parcel
Zone Classification
Residential El
Commercial ❑
d sf�i iC'tl �9 s�(aAt
4.
�/
��.�T -
SEWER El
El Private ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
_
thority to violate or cancel the provlefts of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SME FOR REOUIRE.D.INSPECTIONS
❑Yes F-1 No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation 1
Remodeled Valuation
Total Bldg. Floor Area
5.
Plan Check
PRELIM. FINAL DATE
ADDRESS
ZIP
Main Floor
IUpper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM I TO ' Cover Deck I Uncv. Deck I Fin. Basement I Unfin. Basement
6.
PERMIT NUMBER
5904
9 -,
a
Utilities 144"v
5, v k— TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ��jj 5 9 �j
Tech.g (o IN 180 DAYS DATE �k D2 — 3 PERMIT NO. 6 5 z * 4 5. 0 0 0 -AL
q
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W
J
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No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE 6JNEW ❑ ALT. ❑ AD'N. ❑ RPL. El MVE.
7. OF ❑ OTHER
Certifi. of Exempt.
Required Yes No❑
Number
WORK ❑ BLD. 41 PLMB. ❑ MECH. ❑ M.H. ❑ POOL
or Variance
Received Yes No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.�— /X tJ� 7
Yes Ll Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATERSEWAGE
PUBLIC ❑
SEPTIC ElWAGE
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ❑
SEWER El
El 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
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 provlefts of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SME FOR REOUIRE.D.INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
�'- 3
Mech.
DATE
OWNER OR AGENT DATE
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
�
Planning
/
�ItiG 5 ,.—
Modular/
MFG. Home
Other (Specify)
Fire
Prevent.
Engineer�N
n
PERMIT NUMBER
5904
9 -,
a
Utilities 144"v
5, v k— TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ��jj 5 9 �j
Tech.g (o IN 180 DAYS DATE �k D2 — 3 PERMIT NO. 6 5 z * 4 5. 0 0 0 -AL
q
a
O
U
W
J
M