HomeMy WebLinkAbout1983, 08-11 Permit: 83A-7670 PipingPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHING•ZON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 'r I Z 8 2 +t-_
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
PHONE
PHONE
3. D i L
1
1Z -(.,o 1
MAILING ADDRESS
ZIP
Actual
Actual Set Backs in Feet to:
%7-07-s �� --
l ZI1 - 0 (,p
North South East
West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ONO ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE EW ❑ ALT. ❑ AD DI. F-1 RPL. ElMVE.
7. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB. ECH. 1:1M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ NOD
Number
or Variance
Received
Yes NOD
DES RIBE WORK GAS
8
Shorelines/ Flood Hazard
Plans Required ❑
a
D
Yes Not Applic. ❑
Received ❑
VALUATION
I SOOURCE GAS
ELE TRIC PUBLIC ❑
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
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATIONS
OWNER OR AGENT X DATE — �� —���
i 7,
Mech. 17e—
SPECIAL APPROVALS SPECIAL
PP LIM. FINAL DATE
Env. Health
Planning
Prevent.
Utilities
TIONS: (SEE REVERSE SIDE FOR NOTICE)
Plans PERMIT IS NONTRANSFERABLE
Exam' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building��' IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMITNUMBER
85A -1 &7 p
u4* *i200
i 0
7669
_- 6L7,
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYSSUiD — 8(3 PERMIT7Nv. 7' 0 z
* 12, O 0 fOlTAL