1983, 03-25 Permit: 83A-2228 Plumbing FixturesNUMBER APPLICATION/PERMIT
43 1 SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON -99260 / (509) 456-3675
Engineer
Utilities
SEPA
Pians PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building ti IN 180 DAYS
TOTAL $ n' 0
PERMIT NUMBER
ts--2A - �21_26
a00
4'000
222.7
25-83
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03-25-83 222.82 *53.002)
DATE ISSUED PERMIT NO. TOTAL
a
O
W
J
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
No. Floors
STREET ADDRESS
No. Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
PARCEL NO.
r/�
7. OF ❑ OTHER
LOT
BLOCK
SUBDIVISION
Required Yes❑ No❑
Number
LEGAL DESCRIPTION:
2.
or Variance
Received Yes❑ No❑
DESCRIBE WORK //,
}�c.
Shorelines/ Flood Hazard
Plans Required ❑
OVINER
PHONE
PHONE
VALUATION
SOURCE
OF
MAILING ADDRESS
PUBLIC ❑
ZIP
Actual Set Backs in Feet to:
FEES COLLECTED
9•
UTILITIES
North South East West
PRIVATE ❑
CONTRACTORLICENSE
EXPIRES
PHQ /
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
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 provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
4.
ADDRESS/
/ e"ls�!�T r'LL£':
OWNER OR AGENT DATE
f r
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
/
DESIGNER
PRELIM. FINAL DATE
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
'4: .% .
,.-
SEPA
Modular/
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
,vf� / �s-/f
MFG. Home
Fire
Prevent.
CHANGE OF USE FROM
TO
�
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basement
6.
Other (Specify)
Engineer
Utilities
SEPA
Pians PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building ti IN 180 DAYS
TOTAL $ n' 0
PERMIT NUMBER
ts--2A - �21_26
a00
4'000
222.7
25-83
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03-25-83 222.82 *53.002)
DATE ISSUED PERMIT NO. TOTAL
a
O
W
J
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
❑ BLD. L�IPLMB. ❑ MECH. ❑ M.H. ❑ POOL
WORK
or Variance
Received Yes❑ No❑
DESCRIBE WORK //,
}�c.
Shorelines/ Flood Hazard
Plans Required ❑
8• c_- o i •t. % �i'! c /._ C%iii
yes ED Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS ELECTRIC
PUBLIC ❑
SEWAGE
E❑
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 the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF ' APPLICATIO
Mach.
OWNER OR AGENT DATE
SPECIAL APPROVALS
SPECIAL ONDITION& (SEE REVERSE SIDE FOR NOTICE)
/
Plan Check
PRELIM. FINAL DATE
/Tl��'Z' �- /�•�. %
Env. Health
'4: .% .
,.-
SEPA
Modular/
Planning
,vf� / �s-/f
MFG. Home
Fire
Prevent.
�
Other (Specify)
Engineer
Utilities
SEPA
Pians PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building ti IN 180 DAYS
TOTAL $ n' 0
PERMIT NUMBER
ts--2A - �21_26
a00
4'000
222.7
25-83
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03-25-83 222.82 *53.002)
DATE ISSUED PERMIT NO. TOTAL
a
O
W
J