1983, 09-23 Permit: 83A-9444 Plumbing FixturesPLAN NUMBER APPL ICAT IOM /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE,'WASHINGTON 99260 1 (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS ' PARCEL NO.
2. LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
UV'K .•� "
P N
, ' 1
PHONE
1c
rILING R S
ZIP �f /%
Actual Set Backs in Feet to:
[
4
/'! K'
North South East
West
C ACTOR
-
LICEN PIR
PHONE s/
Size of Parcel
Zone Classification
Residential Eli
4.
?p
L
Commercial ❑
J�eR
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑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.
TYPE NEW El ALT.
❑ AD' N. ❑RPL. 1:1 MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7 OF
WORK ❑ BLD. )&PLMB. ElMECH. ElM.H. ❑ POOL ❑OTHER
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes ❑ No ❑
DESCRIBE WORK
8'
�'
Shorelines/ Flood Hazard
Plans Required ❑
X
Ltu �`
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
SOOUFCE
GAS
I
ELECTRIC
PUBLICO
SEPTIC SEWAGE
Ownership
FEES COLLECTED
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-
thority to violate or cancel t
r isions of any other state or local law regulating construction or the performance
of construction. SEE REV S
1 E FDA'WhOUIRED INSPECTIONS
Plumbing ,f
SIGNATURE OF
APPLICATION per?
OWNER OR AGENT
-
DATE y? !3 7
Mach.
SPECD.`L APPR S SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health /1J— ,�
PRELIM. FINAL DATE ` /— ;� / �GT / L� 1-
%%V�'� ✓�>>'� / n
Planning r [ 'GLsS�✓�i/� L !�✓L���`��
Fire
Prevent.
Engineer — �✓
Utilities
Plans I I I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech mg IN N 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
TOTAL $
WHEN MACHINE VALIDATED IN THIS SP
THIS BECOMES A PERMIT.
OY-23-83
DATE ISSUED PERMINO. 4 4 z * 4 5. O O TOTAL
a
C
LL
LL