1983, 06-07 Permit: 83A-4968 Sprinkler SystemNUMBER 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 1PARCELNO.
'j. ADDRESS
Thi
PHONE
ZIP
y�j�r
"1"�.
LICENSE EXPIRES PHONE
ZIP
ZIP
North South East I West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes [-]No ❑Req'd.
New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
Main Floor Upper Floors Garage/Storage Greenhouse
tWin Basement
CHANGE OF USE FROM
TO
Cover Deck
LOT
BLOCK
2.
6.
I
OWNER
3.��.:o
MAILING ADDRESS
Floors
1E. - 1 V7I
No. Dwellings
CONTRACTOR
4.
ADDRESS
7. OF ❑OTHER
❑ BLD. S/PLMB. ❑ MECH. ❑ M. H. ❑ POOL
'5>qrnL-
Required
DESIGNER
'j. ADDRESS
Thi
PHONE
ZIP
y�j�r
"1"�.
LICENSE EXPIRES PHONE
ZIP
ZIP
North South East I West
Size of Parcel Zone Classification Residential ❑
Commercial ❑
Type Const. Occupancy Sprinklered
❑Yes [-]No ❑Req'd.
New Const. Valuation Remodeled Valuation Total Bldg. Floor Area
Main Floor Upper Floors Garage/Storage Greenhouse
tWin Basement
CHANGE OF USE FROM
TO
Cover Deck
ec
Uncv. Dk
Fm. Basemen
.
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE EW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER
❑ BLD. S/PLMB. ❑ MECH. ❑ M. H. ❑ POOL
empt.
C
Required
Yes❑ NO—E-1--F—Number
WORK
Variance
Received
Yes El No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required El8.
�• Q X21 vU k_C�� f� I. P-CIEV n
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
PBLIC WATER
SEPTIC SEWAG❑
Ownership
FEES COLLECTED
9•UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
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
C3
of construction. SEE REVERSE SIDE FOR OUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATLON -I
Mach.
OWNER OR AGENT DATE -A
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning I
I
Modular/
Pians PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building f IN 180 DAYS
Tech. _ 4�
MFG. Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
er�!mq - ('06
DATE InS6E-0 0 7 — PERMIT rV'07 'B z
•
*9.00°
TOTAL