1983, 09-06 Permit: 83A-8604 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
/o ?IT
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. mi r— Llc 2.3?U
MAILING ADDRESS ZIP Actin
North
4.
W,
5.
ADDRESS
LICENSE EXPIRES P ONE Size of Pan
Type Const
PHONE I New Const
ZIP ■ Main Floor
South East I West
Zone Classification Residential ❑
Commercial ❑
Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
n Remodeled Valuation I Total Bldg. Floor Area
Upper Floors I Garage/Storage I Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Baser
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE t4VEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
Certifi. of Exempt.
Required Yes❑ No❑
Number
WORK ❑ BLD. .<,PLMB. ❑ MECH. ❑ M. H. ❑ POOL
or Variance
Received Yes❑ No[]
DESCRIBE WORKShorelines/Flood
Hazard
Plans Required ❑
8• F/ )"TV t L,>
/�
yes El Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC El
I SEWAGE
El
I Ownership
FEES COLLECTED
9
I UTILITIES
PRIVATE ❑
SEWER El
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
Building
work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provision of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE OR EQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS
SPECIAL CON ITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL
DATE
Env. Health
3 0 415 vS'
r Tv�
SEPA
Modular/
Planning
r SY�-� K
MFG. Home
Fire
Prevent.
y
l W Fl
Other (Specify)
Engineer
3 ✓
Utilities
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE
HEIS BECOMES A PERM TT
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
► ..
DATE i,4at ' Q 6 —8 3
Building
Tech.
PERMIT NUMBER
es A E-41-1
860.3==
09-06-83
6.479.
D IN THIS SPACE,
PERMIT N� 6 0, 4 z * 5 3. c. F
TOTAL
CL
O
V
W
J_
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