1983, 04-05 Permit: 83A-2617 Plumbing FixturesPLAN NUMBER APPLIICATION /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 ADDRESS PARCEL NO.
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
3.
MAILING ADDRESS
4. f `I
ADDRESS�
PHONE
9"R V-&
!�( LICENSE EXPIRES
f�lCJL WJE �/A 1
i /V V y
PHONE
ZIP Actual Set Backs in Feet to:
North South East West
PHONE Size of Parcel Zone Classification Residential ❑
.O S 3411P% Commercial ❑
ZIP Type Const. Occupancy Sprinklered
5cCA6 El Yes ENO ❑Req'd.
9 UTILITIES I 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
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF �y APPLICATION / y
OWNER OR AGENT L��C rv`�' DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
PRELIM. FINAL DATE
Planning
� _ �' r7 Gu•�'2
� r
Fire �� �/-"/ ✓ t J
Prevent. 7-O /S
Engineer _ 1 t.OS
Utilities
SEPA
Plans1 — A -C /�"41111114M IT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Building
Plumbing "e+'6 -c" t
Mech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
*45.00
*450010
A *000
261.6;
04-05-83
z 6479,
E,
DATE ISSUED O — PERMIT 8 3�t,6 1. 7 z * 4 5. OTO AL
a
O
V
W
J_
U.
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
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE
NEW El ALT.
1:1AD' N. El RPL. ElMVE.
7.
OF
�PLMB.
1:1 OTHER
❑ MECH. ❑ M.H. ❑POOL
Certifi. of Exempt.
Required
Yes El No❑
Number
WORK ,BLD.
or Variance
Received
Yes ❑ No ❑
8•,-'/e,
DESCRIBE WORK _"
Shorelines/ Flood Hazard
Plans Required ❑
Ale";
�
Yes 11 Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9 UTILITIES I 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
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF �y APPLICATION / y
OWNER OR AGENT L��C rv`�' DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
PRELIM. FINAL DATE
Planning
� _ �' r7 Gu•�'2
� r
Fire �� �/-"/ ✓ t J
Prevent. 7-O /S
Engineer _ 1 t.OS
Utilities
SEPA
Plans1 — A -C /�"41111114M IT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Building
Plumbing "e+'6 -c" t
Mech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
*45.00
*450010
A *000
261.6;
04-05-83
z 6479,
E,
DATE ISSUED O — PERMIT 8 3�t,6 1. 7 z * 4 5. OTO AL
a
O
V
W
J_
U.