HomeMy WebLinkAbout1983, 12-13 Permit: 83B-2481 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
Shorelines/ Flood Hazard
STREET ADDRESS
Yes Not Applic. ❑
PARCEL NO.
VALUATION
9•
1 . X--,, S-% ;r— A--
ff
C:2 ✓
ELECfRfC
WATER
SEWAGE
EPTI
SEWER O
LOT
BLOCK
SUBDIVISION
UTILLIITIES
LEGAL DESCRIPTION:
2.
I
Public ❑ Private ❑
1 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
OWNERPHONE
<. i 145;e
Building
PHONE
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
3. .�. cx
of construction. SEE REVERS DE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION
�
Mach.
OWNER OR AGENT DATE
MAILING ADDRESS
SPECIAL
APPROVALS
ZIP
Actual Set Backs in Feet to:
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
S� lf_� --e
PRELIM.
FINAL
DATE
North South East West
Plan Check
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
L 5
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
f Z %
s
�,57 64
Prevent.
❑Yes ❑No
❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
Other (Specify)
TOTAL $
Engineer
Utilities
ADDRESS
SEPA°{*
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
PERMIT IS NONTRANSFERABLE
MACHINE IN
HEIS BECOMES A PERMIT.
Plans
CHANGE OF USE FROM
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7_0__
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE El NEW El ALT. El AD' N.
El RPL.
El MVE.
7 OF
El OTHER
WORK El BLD. El PLMB.AC_MECH.
El M.H.
1:1POOL
Certifi.ofExempt.
Required Yes No❑
Number
or Variance
Received Yes❑ No❑
DESCRIBE WORK %r
Shorelines/ Flood Hazard
Plans Required E38'
Yes Not Applic. ❑
Received ❑
VALUATION
9•
SOURCE
GAS
ELECfRfC
WATER
SEWAGE
EPTI
SEWER O
Ownership
FEES COLLECTED
UTILLIITIES
��
PRIVATE ❑
Public ❑ Private ❑
1 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
Building
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 REVERS DE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION
�
Mach.
OWNER OR AGENT DATE
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
e/
Plan Check
Env. Health
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
TOTAL $
Engineer
Utilities
SEPA°{*
PERMIT IS NONTRANSFERABLE
MACHINE IN
HEIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
PERMIT NUMBER
03g 2 e
Tech. 2 IN 180 DAYS I _ _ //'' pp j r p O J
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