1983, 11-08 Permit: 83B-1431 Plumbing FixturesPLAN NUMBER APPL•ICAT ION/ PERMIT
SPOKANE COUNTY - DEPARTIMENt OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS 1129Y 0 3,Q PARCEL NO.
�.
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER ► l _ _ I PWONE PHONE
h 9— J
3.
M (LING AD�+D, RESS �J '
ZI [y /
Actual Set Backs in Feet to:
/710/
Zd /7 l"�
/ ���?
North South East West
C CTOR
LICEN E PIR S
P
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
ERRESSe�;6?Z
Type Const.
Occupancy
Sprinklered
i
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
--[J.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage /Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPEJEW ❑ ALT. ❑ AD' N. F-1 RPL. ❑ MVE.
7. OF - \ ❑ OTHER
El BLD. $,PLMB. ❑ MECH. ❑ M.H. El POOL
Certifi. of Exempt.
Required Yes[ -]No❑
Number
WORK
or Variance
Received Yes ❑ No ❑
DESCRIBE WORK t
Shorelines/ Flood Hazard
Plans Required ❑
8• f4t_Y S
Yes Not Applic.❑
Received ❑
VALUATION
I SOURCE
OF
GAS
ELECTRIC
I WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
] I
FEES COLLECTED
9
PRIVATE El
SEWER 1-1
public ❑Private EJUTILITIES
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 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 pr ions of any other state or local law regulating construction or the performance
of construction. SEE REVERSVSIDOTOR REO D INSPECTIONS
Plumbing _SLL
.'�
SIGNATURE OF APPLICATION 1171
OWNER OR AGENT < DATE �
Mech.
SPECIAL APPROVAI#j SPECIALCODITIONS: (SEE REVERSE SIDE FOR NgIICEE)%
PRELIM. FINAL DATE % J� 1'LA�KG
Env. Health ! L
Planning f
-1�,,/eJ
Fire
Prevent. • , J ��
Engineer Y 11
Utilities /
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 11IN 180 DAYS
U
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
- 14 t
r
TOTAL $ 69/?r
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11=08-85 145,1
DATE ISSUED PERMIT NO.
V
*61.00°
TOTAL