1983, 06-21 Permit 83A-5642 Plumbing FixturesAPPLICATION/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
1.
STREET ADDRESS
6. 172210
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3.
4.
ow
MArr-rgio 13,
CONTO
itg
LICENSE EXPIRES
PHONE
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South
Size of Parcel
ADDRESS
ZIP
Type Const.
Occupancy
11 Zone Classification
West
Residential 0
Commercial ❑
Spr'nklered
❑Yes ❑No 0Req'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7. OF �/'
.�f F'LMB. 0 MECH. 0 M.H. 0 POOL
TYPE 7EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
WORK
❑ BLD.
8 DESCRIBE)pIQRK'k'JR�
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes0
Received Yes
No ❑
No❑
Number
Shorelines/Flood Hazard
Yes NotApplic. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
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 ordinances governing this type of
work will be complied with whether specified herein not. The granting of a permit does not presume to give au-
thority to violalfrerncel . rovisions of any of r state or local law regulating construction or the performance
of construct . SEE REVERSE I%FOR REOUI INSPECTIONS
SIGNATU1 E OF / APPLICATION
OWNER O AGEN I DATE
SPECIALApPRO
PRELIM. FINAL
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
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
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular!
MFG. Home
Other (Specify)
TOTAL $ 124
PERMIT NUMBER
f6"5(04'2-
03* *17,00
56U.1 g
06-21-83
64.79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-21-83 56 4,2 5 *17.00°1-2.
DATE ISSUED PERMIT NO.
TOTAL
East