1983, 10-07 Permit: 83B-113 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3875 5 3O
APPLICANT: COMPLETE NUMBERED SPACES.- PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. .r SUBDIVISION BLOCK S
LOT UBDIVISION
2.
PARCEL NO.
OWNER
3 /So.er nv OOt
MAILING ADDRESS
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
4.
CONTRACTOR
LICENSE EXPIRES
PHONE
Actual Set Backs In Feet to:
North ISouth [East I West
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
ADDRESS
/3z5+ ✓l/ .4r�
ZIP
9SZ-O/
Type Const.
Occupancy Sp nklered
OYes ONo °Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deaf
Uncv. Deck
Fin. Basement
Lint in. Basement
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. ❑ MVE.
7. OF 0 OTHER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
No. Batts
No. Floors
No. Fin. Rooms
No. Dwellings
Celli I. of Exempt.
or Variance
Required YesD No0
Received Yes° Non
Number
DESCRIBE WW1(
�QR (
8. rc-Jfr// C-7; c,
e
Shorelines/Flood Hazard
YesO Not Apollo. 0
Rens Required 0
Received 0
9.
VALUATION SOURCE
UTILITIES
GAS 1 ELECTRIC
WATER SEWAGE,
PUBLIC 0 SEPTIC 0
PRIVATE C 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 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 SCBE FOR REQUIRED INSPECTIONS
SIGNATURE OF i / APPLICATION /
OWNEROR AGEN - .� t a f��� DATE /a' --Cr' est?
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health,[,
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam
Building
Tech.
10/
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)
00
TOTAL $ /I
PERMIT NUMBER
ee -►13
•
04* *19.00
*19.008
A *Q00 E
11.22
10-07-83
2 6479.
ISI
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-07-83
DATE ISSUED
1L35 *19,002e
PERMIT NO. TOTAL ,;