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Home My WebLink About1984, 03-08 Permit: 84A-1966 Furnace, Pipingr"L/1rii Nunn mr1 ArrLIL,M 1 IVIN/ I-'LKM I 1 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 1. DD ESS I F,% rz 1 PARCEL NO. LOT I BLOCK 2. SUBDIVISION LEGAL DESCRIPTION: 3. O NER RAvk 6f s 14 to iJez MAILING ADDRESS Rl.(ciS F 1212a g 0 4. cot it l (04 / I.97io 2..r -AM DESIGNER `ONE h �D13 P � � Sea ZIP? 2 tt LICEpIS7 PI P -4(n �[[y7tt// ��// Y P 71x/6 5. PHONE Actual Set Backs in Feet to: North [South Size of Parcel [East West Zone Classification Residential ❑ Commercial ❑ Type Const. Occupancy Spr nklered ❑Yes ❑No Req 'd. New Const. Valuation Remode ed Valuation Total Bldg. Floor Area ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse 6. CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement TYPE ❑ NEW 7. OF WORK ❑ BLD. ❑ ALT. ❑ AD' N. ❑ RPL. ❑ PLMB. IgMECH. ❑ M.H. DESCRIBE WORKA4 j 8. c�/(/�cj VALUATION 9. SOURCE OF UTILITIES ELECTRI ❑ MVE. ❑POOL ❑ OTHER W TER PU LIC ❑ PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER D No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Shorelines/Flood Hazard Yes❑ Not Applic. ❑ Ownership Public ❑ Private ❑ Required Yes❑ No❑ Received Yes❑ No❑ 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 IDE FOR REQ IRED INSPECTIONS SIGNATURE OF OWNER OR AGENT SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. APPLICATION DATE SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) c I SEvl (,) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Number Plans Requ'red ❑ Received ❑ FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ tt© PEBM)T NUMBER 6� WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE hSfDU " 1 0 6, 6 PERMITfiid. *20 {IOiAL