1983, 11-10 Permit: 83B-1521 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 t,
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNERPHONE PHONE
0
3. MAILING ADDRESS ZIP Actual Set s in Feet to:
CONTRACTOR
4. ADDRESS i C
/4 -ay
5.
ADDRESS
LICENSE EXPIRES
Al k,7 3y�/
ZIP
PHONE
ZIP
North ISouth
Type Const. I Occupancy
East I West
Zone Classification Residential ❑
Commercial ❑
Sprinklered
❑Yes ONO ❑Req'd.
d Valuation Total Bldc. Floor Area
Main Floor I Upper Floors I Garage I Storage
s CHANGE OF USE FROM I TO ' Cover Deck I Uncv. Deck I Fin. Basement I Unfin. Basement
Fire
Prevent. �`c � S � / �% l lX �✓C�
Engineer
Utilities
SEPA //�
Plans ` / PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I t/i /� IN 180 DAYS
Tech.
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 1 C,
DATE tS I D ` U — 7 PERMIT4Id 2, z
i
45,00"
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
❑ BLD. XI PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Exempt.
Required Yes❑ No ❑
Number
WORK
aVarian
Received Yes❑ No El
8. DESCRIBEWORK rt�, �l �j
Shorelines/ Hazard
Plans Required 0
I u �/ '"` RCS' �L
Yes❑ 0
Received ❑
VALUATION
SOURCE
OF
OAS
ECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
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 F OUIRED INSPEC NS
Plumbing
SIGNATURE OF / LICATION
C n �3
Mach.
OWNER OR AGENT DATE
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
—T— _,2 `% —
Env. Health
— �/ C
� (9
SEPA
1 — , / / �-
Modular/
Planning
a / <
MFG. Home
Fire
Prevent. �`c � S � / �% l lX �✓C�
Engineer
Utilities
SEPA //�
Plans ` / PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I t/i /� IN 180 DAYS
Tech.
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 1 C,
DATE tS I D ` U — 7 PERMIT4Id 2, z
i
45,00"