1983, 08-15 Permit: 83A-7773 Plumbing FixturesPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPATMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
ST EET DDRRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. n
E
ENE
cJ
3. MAILING ADDRESS ZIP Actual Set Backs n Feet
North South
E-34 `5 7�
East West
9•
CONT TO
LICENSE
P ES
PHQ
`
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4.
`
ADD
. I PECTIONS
of construction. SEE REVE SIDE F R RE MA
SIGNATURE OF APPLICATIONL
h.3
YY
ZIP
SPECIAL
Type Const. Occupancy
Sprinklered
PRELIM.
FINAL
DATE
Env. Health
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
S � �l4dS -
Fire
Prevent.
ADDRESS
ZIP
-`
�� )
Main Floor Upper
Floors
Garage /Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basemi
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW
❑ ALT. ❑ AD'N. El RPL.
❑ MVE.
7.
OF
BLD.
�1 PLMB. ❑ MECH. ❑ M. H.
❑ OTHER
❑POOL
wVariance empt.
Required Yes❑ NOD
Number
WORK
Received Yes❑ No
Hazard
Plans Required
❑
8,
DESCRIBE WORKShorelines/Flood
S
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWAGE
Ownership
FEES COLLECTED
9•
UTILITIES
PUBLIC LiSEPTIC
PRIVATE ❑
❑
SEWER 11
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
work will be complied with whAher specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel thO Vrovisionbf any other sta or local law regulating construction or the performance
. I PECTIONS
of construction. SEE REVE SIDE F R RE MA
SIGNATURE OF APPLICATIONL
h.3
OWNER OR AGENT DATE
SPECIAL
APPROVALS
SPE IAL CONDI ONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
Env. Health
Planning
S � �l4dS -
Fire
Prevent.
Engineer
-`
�� )
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building (' 1Aj_' I IN 180 DAYS
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
A-7_7_3
(\ 7 7 0
V V
* 7' 7 i4 C'
77',2_ -
TOTAL $ t
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Q 0 1 —8 3 7 7 7 d
DATEiW_ Dy PERMIT4d. /' 3 z
* 7 3.0 O'PotAL