1983, 11-28 Permit: 83B-2023 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
s CHANGE OF USE FROM T TO ' Cover Deck I Uncv. Deck Fin. Basement I Unfin. Basement
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
No. Floors
STREET ADDRSS
No. Dwellings
TYPE A_NJH W ❑ ALT. ❑ AD'N. 1:1 RPL. ElMVE.
PARCEL NO.
7. OF ❑ OTHER
[Y-1 IB. ❑ MECH. ❑ M.H. POOL
LOT BLOCK
SUBDIVISION
t
LeGAL DESCRIPTION:
2.
Number
WORK '
or Variance
Received
Yes❑ NOD
OWNER • i
PHONE�
PHONE
3.
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
MyILING ADD
fL-
Ownership
ZIP
20 (e
Actual Se Backs in eet to:
9
UTILITIES
Northtmouth East West
4'
RLCUR
LICENSEPE
P O E,�/(O.� /
J
Size of Parcel
Zone Classification
Residential
Commercial ❑
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
DR ,/ % <�(/
d 6 X / I 4\ (P
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
ZIP
lyl
Type Const.
Occupancy
Sprinklere0d
Dyes ONO ❑Req'd.
Plumbing
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5
Plan Check
PRELIM. FINAL DATE
v
Env. Health
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
s CHANGE OF USE FROM T TO ' Cover Deck I Uncv. Deck Fin. Basement I Unfin. Basement
PERMIT NUMBER
Utilities � p 6b A- TOTAL $ �`
SEPA
GfIgi/'110 WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 7t0 iN 180 DAYS 12 0 — n 3 2 3 ° * 4 9. n 0 ° �.
TEch. _ €SATE ED PERMIT, (i. )T.4L
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE A_NJH W ❑ ALT. ❑ AD'N. 1:1 RPL. ElMVE.
7. OF ❑ OTHER
[Y-1 IB. ❑ MECH. ❑ M.H. POOL
Certiti. of Exempt.
Required
Yes❑ NOD
Number
WORK '
or Variance
Received
Yes❑ NOD
DESCRIBE K
8.
Shorelines/ Flood Hazard
Yes 11 Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ❑
SEWER El
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
Building
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 IDE R QUIRE INSPECTIONS
Plumbing
SIGNATURE OF APPLICAT19N
OWNER OR AGENT DATE Z/-06-60_3
Mech.
SPECIAL APPROVALS
S: (SEE REVERSE SIDE FOR NOTICE)
SPECIAL CON7;7
Plan Check
PRELIM. FINAL DATE
v
Env. Health
SEPA
Planning
��t/V
Modular/
MFG. Home
Fire
_
Prevent.
Other (Specify)
Engineer
PERMIT NUMBER
Utilities � p 6b A- TOTAL $ �`
SEPA
GfIgi/'110 WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 7t0 iN 180 DAYS 12 0 — n 3 2 3 ° * 4 9. n 0 ° �.
TEch. _ €SATE ED PERMIT, (i. )T.4L