1983, 10-11 Permit: 83A-238 Plumbing FixturesPLAN NUMBER ff. 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
1 STREET ADDRESS // ^ PARCEL NO.
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER /' ` R �7�� 5__ /
L,
7 i
PHONE
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East
West
CONTRACTOR —�— (� /
LIC�ElNSEEXPIRES
PHOlN�ESize
3
of Parcel
Zone Classification
Residential ❑
Commercial ❑
.ly
a
4.
ADDRESS ,.s /��
4 dC6�r �Oc.3
ZIP
t- 1
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑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
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW El ALT. El AD'N. 1:1 RPL. El MVE.
% OF
BLD. �PLMB. MECH. ❑ M.H. ❑ POOL ❑ OTHER
Certifi. of Exempt.
Required
Yes❑ No El
Number
WORK
or Variance
Received
Yes❑ No❑
8. DESCRIBE WORK
/tom/ �'�
Sh�or❑elinesNoloodplazar❑d
red 0
Plans ReqReceived
0 / J
❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
I WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
I
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
1�
of construction. SEE REVERSE SIDE FOR REQUIRED INP±ECTIONS
Plumbing
SIGNATURE OF` APPLICATION / �1�
C)WNFR nR AGFNT _ 2-!�� DATE �� 7
Mech.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Engineer
Utilities
Plans
Exam.
Building O
Tech. / i
SPECIAL CONDITIONS:
(SEE REVERSE SIDE FOR NOTICE)
�A-us - 3
�y} gni - / 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 $ 5
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
n
PERMIT NUMBER
'Z-_�>; "�
1
DATE ISSUED PERMIT NO.'o* 0 +OjAL