1983, 09-27 Permit: 83A-9586 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
STREETADDRESS _ PARCEL NO.
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
SPECIAL
OWN R `
PP
PL-IONE.
PHONE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR INT11
Env. Health
3.
�M
ING ADD S
ZIP
Actual Set Backs in Feet to:
1r,I ,LCA`
North South East
West
— / 1 •� 1�
CQrThACfOR
IGEN EE P S
PH
"
Size of Parcel
Zone Classification
Residential❑
4.
z' ,�',
a
Commercial ❑
D
ZP
Type Const.
Occupancy
Spr rte
SEPA
Plans
Dyes ❑No❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Building
Tech.
n
IN 180 DAYS
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7.
�A(EW El ALT. 1:1 AWN. El RPL. El MVE.
OF
WORK ❑ BLD. LMB. ❑ MECH. ❑ M.H. 1:1 POOL ElOTHER
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
8•
DESCRIBE WORK / ti
Shorelines/ Flood Hazard
Plans Required ❑
X
Yes Not Applic. ❑
Received ❑
VALUATION
I SOOUFCE
GAS
ELECTRIC
WATPUB LIC El
SEPTIC El
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 t p visions of any other state or local law regulating construction or the performance
I+et,
of construction. SEE REV RS S DE FO EOU ED INSPECTIONS
Plumbing z
CATION
SIGNATURE OFL� '
OWNER OR AGENT ` t C_� DATE
Mach.
SPECIAL
APP
PRELIM.
OV
FINAL
LS
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR INT11
Env. Health
,;z
Planning
— / 1 •� 1�
Fire
Prevent.
Engineer
1; ILI
PERMIT IS NONTRANSFERABLE
Utilities
SEPA
Plans
Exam.Ns,
ZIS
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech.
n
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
PERMIT NUMBER
r6
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6,9`27-�3 958.626
DATE ISSUED PERMIT NO.
*65.00+O�AL
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