1983, 04-27 Permit: 83A-3387 FurnacePLAN NUMBER
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.
PARCEL NO.
LOT
2.
BLOCK SUBDIVISION
OWNEIj
3. -P7L.Jcie—NIANi
MAILING ADDRESS
1('2 g K�
CO T
4.G
DNSS5
DESIGNER
5.
PHONE
LICENSE EXPIRES
PHONE
ZIP
PjIONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South [East 1 West
Size of Parcel
Zone Classification
V
Type Const.
Occupancy
Residential ri
Commercial 1=1
Spr'nklered
f (Yes FINo fReq'd.
ADDRESS
CHANGE OF USE FROM
6.
TYPE ❑ NEW
7. OF
WORK ❑ BLD.
DESCFjIB�VyOR
8. (q �
HONE
ZIP
TO
❑ ALT. ❑ AD' N. 0 RPL. ❑ MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
VALUATION
9.
SOURCE
OF
UTILITIES
Ce r
GAS
ELECTRIC
0 OTHER
WATER
PUBLIC 0
PRIVATE n
SEWAGE
SEPTIC 0
SEWER 0
New Const. Valuation
Remode ed Valuation
Main Floor
Upper Floors
Garage/Storage
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yesi i No'
Received Yes,- No—
Unfin. Basement
No. Dwellings
Number
Shorelines/Flood Haze d Flans Required
Yes: Not Applic. Received
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 . - ons of any other state or local law regulating construction or the performance
of construction. SE ERS • SI ' - FOR REOU D INSPECTIONS
SIGNATURE O' / APPLICATION
OWNER OR A
DATE
SPECIAL APPROVALS S CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
:PRELIM. FINAL DATE
Env. Health
Planning
Flre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PIPS (27)`
X21'
11 (7
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 $
PERMIT NUMBER
3h\ -3387
64* *1800
*18006
A *Q00 0
338.68
04-27-83
4 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATAsira 7 -8
PERMIT3NO. 8.7 z
*18,OOAL