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1984, 04-03 Permit: 84A-2842 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. 1. F_ , 1 \--!> 1 S 2G'1T1A LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION: 2. OWNER PHONE PHONE olc M ►CIA ec�_1 1 1 G24 -ca. -es MAILING ADDRESS_ ZIP Actual Set Backs in Feet to: EE . 1142s 1� ac17-©(- North South East West CONTRACTOR LICENSE EXPIRES ?,L1 ONE Size of Parcel Zone Classification Residential I�KI�'S �� urr,�(z;7 ,t Commercial ❑ 4. ADDRESS ZZIIP,� Type Const. Occupancy Planning Sprinklered 1 ( 1515 _ F �p\�t< ❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area Prevent. 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 6. Utilities No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE 2"NEW LT. 11AD' N. El RPL. 1:1MVE. t Sr'.wto�.E ���TGoZ oz o 1-4 %2 SEPA 7• OF ❑ OTHER YPILMB. Certifi.ofExempt. Required Yes❑ No❑ Number WORK ❑ BLD. ❑ MECH. ❑ M.H. ❑ POOL PERMIT IS NONTRANSFERABLE or Variance Received Yes❑ No❑ DESCRIBE WORK Shorelines/ Flood Hazard Plans Required El 8 15 j7(K rL e<Z> Yes❑ Not Applic. ❑ Received ❑ VALUATION I SOURCE OF GAS ELECTRIC I WATER PUBLIC ❑ SEWAGE SEPTIC ❑ Ownership FEES COLLECTED 9. 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 of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing BOO SIGNATURE OF / APPLICATIONPZ t OWNER OR AGENT DATE Mech. SPECIAL APPROVALS PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE 4'- t -o L QTS 40- C�1A V Env. Health ,t Planning t SWOv.SEiw— Fi re Prevent. 1 VC L T Sr N K_ Engineer Utilities t Sr'.wto�.E ���TGoZ oz o 1-4 %2 SEPA PERMIT IS NONTRANSFERABLE Plans Exam' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Tech ing ill 712-F Plan Check SEPA Modular/ MFG.Home Other (Specify) PERMIT NUMBER TOTAL $ 22 c I WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. ��11QQ _ ))RR /� o DATEYSSUE� PERMIl�N9. ` z * 7 0, O 0 IAL