1983, 12-19 Permit: 83B-2644 Mechanical 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
STREETADDRESS PARCEL NO.
' E. 12421 30th
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
11 Nish Sar:foulian
MAILING ADDRESS
E. 12421 - 30th
PHONE PHONE
924-1525
ZIP Actua
11A 99216North
South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Valley Fireplace
1%84
922-2780
Commercial ❑
4
ADDRESS
ZIP
Type Const .
Occupancy
Spri nklered
E. 16610 Sprague Ave, Ve adale '.,',[A
99037
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Contr. License 4VVAL1.,6'F-177CG
5
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/
Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE LA�EW El ALT. El AD'N. ❑RPL. ❑ MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7 OF ❑OTHER
WORK ❑ BLD. El PLMB.XMECH. ❑ M.H. El POOL
Certifi.ofExempt.
Required
Yes El No❑
Number
or Variance
Received
Yes El No❑
DESCRIBE WORK I X1 rIN
Shorelines/ Flood Hazard
Plans Required El8
Installation of LOPI "SX" Insert into h.asonr Fire lac
Yes NotAppiic. ❑
Received ❑
.
VALUATION
9•
I SOOUFCE
F
GAS ELECTRIC
WATER
PUB IC El
SEWAGE
SEPTIC ElOwnership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private7E�
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 complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVS SE §IRE FOR REQUIREDINSPECTIONS
Plumbing
SIGNATURE OF r APPLICATION r^
'
0�
OWNER OR AGENT �- _ _ ( DATE —_.
Mech.y"
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
Planning
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE ,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /� IN 180 DAYS
Tech. o I l
SEPA
Modular/
MFG. Home
Other (Specify)
J%
TOTAL $_ 2 �
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES nMES A PERMIT.
DATE�ED 7 U PERMITNO.
PERMIT NUMBER
x,13' �44
C U. 0 0 TOO rAL
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