1983, 09-20 Permit: 83A-9268 Furnace, Heat PumpPLAN NUMBER
APPLICATION/PERMIT 81cl
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 53pO I S
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. /ioo9
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3-101:57rr.,ctc
MAILING ADDRESS
fl /---e—
CONNTTTRRACTOR LICENSE CENSE EXPIRES
4. .40 /CIPr ZL- .� Zeit Ort
ADDRESS
/ iy/ mil �i r /'
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North 'South
East
West
PHONE
3 ZG f roIJ
Size of Parcel 1 Zone Classification
Residential 0
Commercial n
ZIP
4 zed
Type Const.
Occupancy
Sp nklered
DYse UNo OReq'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 Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW
7. OF
WORK 0 BLD.
0 ALT. 0 AD' N. 0 RPL. 0 MVE.
0 PLMB.., MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No Fin Rooms
No. Dwellings
Certif 1. of Exempt
or Variance
Required Yesn Non
Received YesO Non
Number
�DpCR11,3fr MDT<
ALUATION -SOURCE I GAS
UTILITIES
OF
9.
a.gct aeldzt lc.2aU %
ELECTRIC
WATEFY
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC n
SEWER 0
Shorelines/Flood Hazard
Veen Not Applic 0
.t-c-/�
Okmership
Public 0 Private U
Pans Required n
Received n
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 REVER IDE FOR REOUIRED,INSPECTIONS
OWNER
OF L�/ O // '/� APPLICATION g �/
OWNER OR AGEN B �,fGLS/. LL..AJ.r2i DATE / �S' d 3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
4 '€ c �r. U/ . ,tec c e -
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Misch
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
/7 O0
TOTAL $
PERMIT NUMBER
b A-72-42
KEY:
04`* *19.00
* 1 9.006
A *0.00
92672
09-20-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• 09L2p1-'8.3
DATE ISSUED '
PERMIT N2."' 8 z
*1'9.0 0 4liTAL