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1983, 10-07 Permit 83B-991 Gas PipingPLAN NUMBER A!'t'LI(. A I IUIV / rtrinn I I SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WA3RINGT-ON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS . ! iquo ► I 7 2. � BLOCK S IRISION 1. OWN 4J).J G 3. fv�,.11LLrtf MAILING ADDRESS I V:12 M^tiy�-1 I -0 coNT_R/ k1R(G> w 4. ���1J11 ADDRESS PHONE LIC_NSE EXPIRES PHONE ZIP PHONE ZIP PARCEL NO. LEGAL DESCRIPTION: Actual Set Backs In Feet to: North (South [East I West Size of Parcel 1 Zone Classification Type Const. Occupancy Residential ❑ Commercial 0 Sprinklered ❑Yes ❑No ❑Req'd. DESIGNER 5. ADDRESS PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM 6. TO TYPEEW ❑ ALT. 0 AAD'N_ 0 RPL. ❑ MVE. 7. WORK 0 BLD.0 PLMB.2 ECH. ❑ M.H. ❑ POOL 0 OTHER Cover Deck No. Baths Uncv. Deck No. Floors Fin. Basement No. Fin. Rooms Unfin. Basement No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yes❑ No❑ Number 8. 9. DESCRIB�j(VO�K /�NI 61 (V+,t 1 VALUATION_TITISOURCEgLGAS ELEVI(jRIC OF UTILITIES Shorelines/Flood Hazard Plans Required 0 Yes ❑ Not Applic. ❑ Received ❑ WATER PUBLIC ❑ PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER 0 Ownership Public 0 Private 0 I hereby certify that 1 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- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR R • IRED INSP TIONS SIGNATURE OF ,_�� � i PTELICATIO OWNER OR AGENT-� SPECIAL APPROVALS PRELIM. FINAL DAT Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. J`% SPECIAL C• NDITIONS: (SEE REVERSE SIDE FOR NOTICE) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS FEES COLLECTED Building Plumbing Mech. I Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ 04* *1200 *12.006 A *000 9,02 10-07-83 g 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 10 -0 7 - 9.1z DATE ISSUED PERMIT NO. TOTAL