1984, 02-29 Permit: 84A-1689 Plumbing FixturesPLAN NUMBER 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
STREET ADDRESS ' PARCEL NO.
,. �1 i1 -
LOT I BLOCKS BDIVISION LEGAL DESCRIPTION:
2. M rv-� l I r
nIAinicc IPHONE 1PHONE
3. r �k. V m I"'.—
Upper Floors
MAILING ADDRESS
Greenhouse
C�rI� TOR
?' �PT OR �'C'60r-'f
�
4.
Unfin. Basement
A
DRESS
. Z
No. Fin. Rooms
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
TO
s.
ZIP Actual Set Backs in Feet to:
North South East West
LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential ❑
�/t. -� Commercial ❑
ZIP `� i Type Const. Occupancy Sprinklered
A ❑Yes ❑No ❑Req'd.
1' PHONE ✓ New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
ZIP
TYPE XNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
7. OF _
WORK ❑BLD. .� PLMB. ❑ MECH. ❑ M.H. ❑POOL Certei� of Exempt. Required Yes❑ No❑ Number
or Received Yes ❑ No ❑
DESCRIBE WORK (�
Shorelines/ Flood Hazard Plans Required ❑
8. (� i Yes Not Applic. ❑ Received ❑
VALUATION I SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9• UTILOIF PUBLIC ❑ SEPTIC ❑ Public ❑ Private EJPRIVATE ❑ SEWER ❑
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 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 W
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF / APPLICATION
nWNFR nR A[,FNT '�� [ti'n'es DATE Mech.
SPECIAL APPROVACS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
PRELIM. FINAL DATE
� OPq1/�,,4�-�6
Planning :3 liven- 0,4,07 JF -r
Fire -
Prevent. r'
Engineer
12-
(A) 64
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building // IN 180 DAYS
Tech. 7./'�
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMr��6
t,4A J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. 11 ,(( n
DATEQS�E� 9 _ 8 5 8
PERMITW. 8. 9 0 * , O O *OirAL