1983, 04-12 Permit: 83A-2847 Plumbing FixturesPLAN NUMBER APPLICATION /PERMIT PERMIT NUMBER
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 STREETADDRESS 16113
O1/3 PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER 'j?w
3.
MAILING ADDRESS
PHONE (PHONE '
Zip Actual Set Backs in Feet to:
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE j
Env. Health J w e—
Planning I Tccvd
Fire (� v 6G CV V IV - J,
Prevent. `f pc
Engineer / Wjf*&-
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
U
L
E,
DATE lrS D 12 —
2_ 8 3 PERMIT 208 [. 7 z * 5 7, Q N�41L
North ISouth I East
I West
CON IICTOR
GTd��fi,LlSc'�+/AO/aAy
LIC SE EXPIRES
PHONE.
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4. ADDRE$ f; lrac
//
*1 w//
„(ro
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
GaragelStorage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE 4y NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
❑ BLD. 9PLMB. ❑ MECH. ❑ M.H. ❑ POOL
or VarianExempt.
Required
Yes El No❑
Number
WORK \\
Received
Yes No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
I WATER
PUBLIC El
SEWAGE
SEPTIC El
Ownership
FEES COLLECTED
9
I 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 provi . ns of y other state or local law regulating construction or the performance
S-2 4t—
of construction. SEE REVERS FOR RE UIR SPECTIONS
Plumbing ,_
SIGNATURE OF APPLICATION
OVVNFR OR AGENT DATE -
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE j
Env. Health J w e—
Planning I Tccvd
Fire (� v 6G CV V IV - J,
Prevent. `f pc
Engineer / Wjf*&-
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
U
L
E,
DATE lrS D 12 —
2_ 8 3 PERMIT 208 [. 7 z * 5 7, Q N�41L