1983, 07-11 Permit: 83-6353 FurnacePLAN NUMBER APPL ICAT ION4�PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
RIVATE ❑ SEWER ❑ 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 RE UIRED INSPECTIONS
SIGNATURE OF— APPLICATION
OWNER OR AGENT`- - /� ` ' . v / /. f. DATE—
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent. I
Engineer
Utilities P
Plans PERMIT IS NONTRANSFERABLE
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Teching IN 180 DAYS
04* * 1 6.00
*1600
A *0,00
635,22
07-1 1 -83
� 6479.
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ =1_
WHEN MACHINE VALIDATED IN THIS SPACE
THIS BECOMES A PERMIT.
07-83 635.32
DATE ISSUED PERMIT NO.
*16,00°
TOTAL
:11-
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11�
APPLICANT: COMPLETE NUMBERED SPACES -PRESS
HARD TO MAKE 3 COPIES
STREFTADDRESS
PARCEL NO.
2.
J:Bt,!,]LOT
SUBDIVISION
LEGAL DESCRIPTION:
OWNERPHONE
PHONE
3.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
North South East West
CONTRACTOR
,
LICENSE EXPIRES
PHONE -
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
A ESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. BasemE
7•
TYPENo.
❑NEW
El ALT. ❑ AD'N. ❑RPL. El MVE.
Baths No.
Floors
No. Fin. Rooms
No. Dwellings
OF
WORK 1-1 BLD.
ElPLMB,.Q MECH. ElM.H. ❑ p L ❑OTHER
Certifi.otExempt.
Required Yes LJ No❑
Number
or Variance
Received Yes❑ No❑
DES hB WQQgRRRK
(
>
f
Y �L
Shorelines/ Flood Hazard
Plans Required El8.
'
Yes El Not Applic. ❑
Received ❑
9.
9,
VALUATION
SDLfFjtE
UTIT
IES
GAS
ELECTRIC
WATER
PUBLIC El
p
SEWAGE
❑
Ownership
FEES COLLECTED
RIVATE ❑ SEWER ❑ 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 RE UIRED INSPECTIONS
SIGNATURE OF— APPLICATION
OWNER OR AGENT`- - /� ` ' . v / /. f. DATE—
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent. I
Engineer
Utilities P
Plans PERMIT IS NONTRANSFERABLE
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Teching IN 180 DAYS
04* * 1 6.00
*1600
A *0,00
635,22
07-1 1 -83
� 6479.
Building
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ =1_
WHEN MACHINE VALIDATED IN THIS SPACE
THIS BECOMES A PERMIT.
07-83 635.32
DATE ISSUED PERMIT NO.
*16,00°
TOTAL
:11-
a
O
V
W
J
LL