1983, 10-21 Permit: 83B-721 Gas HeaterPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBEHED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
. /
LOT BLOCK
2.
Asr2N4
PARCEL NO.
SUBDIVISION
3.
O
MAILING ADDRESS
t .1 Ii
Aso S
PHONE
Zxl,
> -
. P NE
'� zl
9-3
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South
East
West
CONTAic R
4. ADDRESS
LICENSE EXPIRES
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No Reg 'd.
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
TYPE NEW
7. OF
WORK ❑ BLD.
PHONE
ZIP
TO
❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
❑ OTHER
❑ PLMB.f MECH. ❑ M.H. ❑ POOL
8. DESCRIIB`E�WOR
VALUATION
9.
S URCE
UTILITIES
GAS
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage /Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
YesD No❑
YesE No
Number
. CIONi61
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Shorelines /Flood Hazard
Yes❑ Not Applic. ❑
Ownership
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 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 REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION n
DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env roan
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
*1600
*16006
*0.00
72.08
10-21-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATETSSUED2 1 — 8 3
PERMIT NO. 2. 1 z * 1 6. 0 0 t'oNaL