1984, 03-14 Permit: 84A-2214 Plumbing FixturesPLAN NUMBER
APPLICATION /PERMIT
No. Floors
No. Fin. Rooms
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
7. OF ❑OTHER
WORK ❑ BLD. KPLMB. ❑ MECH. ❑ M.H. ❑ POOL
Env. Health
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HNRD .O MAKE 3 COPIES
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE
8.�
STREET ADDRESS
Shorelines/ Flood Hazard
Yes❑ Not Applic.❑
PARCEL NO.
VALUATION
9•
SOUR OFCE
UTILITIES
3-3
ELECTRICTIPUBLIC
❑
PRIVATE ❑
LOT
BLOCK
SUBDIVISION
FEES COLLECTED
Building
1 tr v�
Plumbing _
Mach.
LEGAL DESCRIPTION:
2.
Prevent.
I
I
IJiS il,.ta�45 1.-C.v
O NERPHONE
PHONE
Utilities
3
—lx�y- 'l h.
SEPA
MA G ADD ESS
ZIP
Actual Set Backs in Feet to:
PERMIT IS NONTRANSFERABLE
!917� 2—
'?Z&
North South East West
Exam.
CO T ACT
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
7�/
Commercial ❑
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
[]Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
J.
ADDRESS
ZIP
Main Floor
per Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unf in. Basement
s.
TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
7. OF ❑OTHER
WORK ❑ BLD. KPLMB. ❑ MECH. ❑ M.H. ❑ POOL
Env. Health
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE
8.�
K
Shorelines/ Flood Hazard
Yes❑ Not Applic.❑
Plans Required ❑
Received ❑
VALUATION
9•
SOUR OFCE
UTILITIES
GAS
ELECTRICTIPUBLIC
❑
PRIVATE ❑
SEPTIC SEWAGE
SEWER ❑
Ownership
Public ❑ Private ❑
Fire
FEES COLLECTED
Building
1 tr v�
Plumbing _
Mach.
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 compiled with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provipiQQs of any other state or local law regulating construction or the performance
of construction. SE11211TIMERSE SIDE FOAREQUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGEN DATE_ T
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
�-
3_
Env. Health
1 ��/.
Planning
,� —S0XS
Fire
Prevent.
IJiS il,.ta�45 1.-C.v
Engineer
Utilities
—lx�y- 'l h.
SEPA
PERMIT IS NONTRANSFERABLE
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building
7�/
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify) 16 4,1414,141_
pc.
TOTAL $
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
.48 DATE19UED� — 4 PERMITN� LL 4 z * / 0. U 0 0 -j