1983, 07-08 Permit: 83A-6306 Plumbing FixturesBER APPLIICAT[ON /PERMIT
SPOKANE COUNTY — DEPARTMEKT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
CHANGE OF USE FROM TO Cover Deck Uncv. UBCK Fin. Basement Untin. Basement
6.
PERMIT NUMBER
�* *�?.�'
(i v
* 7 'v
*(�
G7 C,.
No. Baths
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
,.
STREETADDRESS
_
b � ,
PARCEL NO.
7. OF ❑OTHER
❑ BLD. �PLMB. ❑ MECH. ❑ M.H. ❑ POOL
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
Number
I
or Variance Received
Yes❑ No❑
OWNER
�!� �LA -r'4
PHONE
PHONE
3.
c
Yes El Not Applic. ❑
Received ❑
MAILING ADDRESS
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
OF PUBLIC ❑ SEPTIC ❑
9 UTILITIES PRIVATE ❑ SEWER El Public El Private ❑
I
ZIP
ua t ks In Feet to:
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions Included on
North South East West
Building
CO RACTOR
LICENSE EXPIRES
PHONE,
Size of Parcel
Zone Classification
Residential ❑
thority to violate or cancel the pro,visivirm,of any other state or local law regulating construction or the performance
O
/�f�dhf IJ�X (,cFel
of construction. SEE REVERS DE FOR REQUI INSPECTIONS
Plumbing ..�7
Commercial ED
SIGNATURE OF APPLICATION
ADDRESS
(S'-2
/r7o-4.1L
ZIP /
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Env. Health
3 �R> /a''
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. UBCK Fin. Basement Untin. Basement
6.
PERMIT NUMBER
�* *�?.�'
(i v
* 7 'v
*(�
G7 C,.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
_
b � ,
TYPE SEW ❑ALT. ❑ AD' N. ❑RPL. ❑ MVE.
7. OF ❑OTHER
❑ BLD. �PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Cartifi.ofExempt. Required Yes❑ No❑
Number
WORK
or Variance Received
Yes❑ No❑
DESCRIBE WORK
8. , Fly -"U'C fs
Shorelines/ Flood Hazard
Plans Required ❑
-
Yes El Not Applic. ❑
Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
OF PUBLIC ❑ SEPTIC ❑
9 UTILITIES PRIVATE ❑ SEWER El Public El Private ❑
I
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 pro,visivirm,of any other state or local law regulating construction or the performance
L'
of construction. SEE REVERS DE FOR REQUI INSPECTIONS
Plumbing ..�7
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE 3
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
3 �R> /a''
SEPA
Planning l
25 s
Modular/
MFG. Home
Fire
Prevent. l !
Q
Engineer
Other (Specify)
c.3
LAJ
J_
Utilities
as.
U.
TOTAL $
SEPA
MACHINE IN
THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERM TTED
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building - 7@ IN 180 DAYS
Tech.
%►• 0 8' 8 3
0,6 z
fl
* 5 3, U 0 O H
C7
DATE ISSUED PERMIT
NQ.
TOTAL