1984, 04-13 Permit: 84A-3350 Plumbing FixturesPLAN NUMBER APPL ICAT ION'/ 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
STREET+ DRESS .� „ n PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
.,
V
r
U
OWNER . ` l
PHONE
PHONE
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East
West
CONTRA TO Q
N
LICENSE EXPIRES
P�IQQf��E Q
'0 f_
Size of Parcel
Zone Classification
I I
Residential ❑
4
V I
7iG(I l,�
Commercial ❑
ADDRESS
� . ( h^
21' 0 ��
Type Const.
Occupancy
� 'v /
❑YDyesSpr❑Nor� ❑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
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TTO
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE RS.NEW El ALT. El AD'N. El RPL. ❑ MVE.
7.
O❑OTHER
WORK ❑ BLD. XCPLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No
Number
or Variance
Received
Yes El No❑
8
DESCRIBE WORK r nv
j� 1
Shorelines/ Flood Hazard
Plans Required ❑
Yes El Not Applic. ❑
Received ❑
9•
VALUATION
I SOOURCE
GAS
ELECTRIC
WATER
PUBLIC 11SEPTIC
SEAGE
El IC
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
b to
of construction. SEE REVERSE. SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF -1APPLICATION,/
OWNER OR AGENT DATE
/ 3 —
Mech.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
PER T NUMBER
-- �3 ,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE f55UED1 5 PERMIT��
— 5' O z
*58.0000❑.
TOTAL
CL
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W
J
LL
.,
V
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WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE f55UED1 5 PERMIT��
— 5' O z
*58.0000❑.
TOTAL
CL
O
v
W
J
LL