1983, 04-19 Permit 83A-3054 Plumbing FixturesPLAN NUMBER
l %
APPLICATION/PERMIT
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
STREET ADDRESS
1. /39,73 44104)oua• ofy
LOT BLOCK SUBDIVISION
2.
3.
OWNER
l I *At:4rF ee,
MAILING ADDRESS
PHONE
CONTRACTOR_ _ 1 LICENSE EXPIRES
4.
ADD SS
4267-? Fay- sS /-
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
4 N3yAy
zlefiroar
PHONE
ZIP
TO
TYPE VIEW 0 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF OTHER
WORK ❑ BLD. &PLMB. 0 MECH. ❑ M.H. ❑ POOL ❑
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North
South East
Size of Parcel
Type Const.
Occupancy
New Const. Valuation
DESCRIBE WORK
8.
VALUATION
9.
/O 7cg,c rf
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER 0
Main Floor
West
Zone Classification
Residential O
Commercial ❑
Spr'nkiered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Upper Floors
Cover Deck
No. Baths
Garage/Storage
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes0 No❑
Received Yes Nor
Shorelines/Flood Hazard
Yes Not Applic. ❑
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 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 pro of any other state or local law regulating construction or the performance
of construction. SEE REVERS 'S • E FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNEh OR AGENT
APPLICATION I `� ,
DATE ``77
SPECIAL APPROVALS
c PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Lffilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
54-
03* *4500
*45,006
A *0.00 8
30532
04-19-83
2 6479.
CuI F rnav
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
OISSUED 9 - 85
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