1983, 06-06 Permit 83A-4838 Plumbing FixturesPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
4 e
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
C-
3 N2lb
MAILING ADDRESS
4.
COATRACTOR
oW .55Ac_
ADDRESS
32 (:%3 C
cC41440N-4�/ itrx
PHONE
LICENSE EXPIRES
PHONE
ZIP
PHONE ar'Vc"r
z' qp/
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South
Size of Parcel
Type Const.
Occupancy
East
West
Zone Classification
Residential 0
Commercial 0
Sprinklered
0Yes ❑No ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 6-NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7 OF WORK 0 BLD. �PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER
No. Baths
No. Floors
No. Fln. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No0
Received Yes ❑ No❑
Number
S.
DESCRIBE WORK
/6 F-s<
Shorelines/Flood Hazard
Yes ❑ NotApplic.0
Plans Required ❑
Received ❑
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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 ordlnances 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-
thority to violate or cancel the provlsl. • .f any other state or local law regulating construction or the performance
of construction. SEE REVERSES
OUIRED INSPECTIONS
SIGNATURE OF APPLICATION ,
OWNER OR AGENT / DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
6,2 s/a-'-r
Alt-' "
re
cc od."4-
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing g
re—
Mech.
Plan Check
SEPA
Modular/
MFG, Home
Other (Specify)
14541.6
TOTAL $
03* *45.00
*45.00'6
A *0.00
48372
06-06-83
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06 -0 6 -8 3
48385
*45,00a,
DATE ISSUED
PERMIT NO. TOTAL
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