HomeMy WebLinkAbout1983, 09-16 Permit: 83A-9122 Furnace, Heat PumpPLAN 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
1. EETACDRESS 1 FSoA1a
PARCEL NO.
LOT
2. y�+ II
3. OWNER
W 14I%gi
MAILING ADDRESS
BLOCK
SUBDIVISION
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
4. GZ i 2 i ►-r�I �G
ADQft-ES
� Binz
LICENSE EXPIRES
Actual Set Backs in Feet to:
North I South I East I West
Size of Parcel
Zone Classification
Residential 0
Commercial 0
Type Const.
Occupancy
Spr nklered
°Yes DNo .UReq'd.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Man Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
TYPE FINEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF WORK 0 BLD. 0 PLMB. a(MECH. 0 M.H. 0 POOL ❑OTHER
RIB
DESCE�y r ORK I
8. L. it2nl ( 14"eirefoki
Il( ft/Mr,
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
CertlfI. of Exempt.
or Variance
Required Yes° NoD
Received Yes NoD
Number
Shorelines/Flood Hazard
YesD Not Apolic.0
Plans Requ red 0:
Received 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined this appl cation 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 REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
DATECATION sNv 7 /G/19T3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plana
Exam.
Building
Tech.
740
SPECIALONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
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)
TOTAL $
PERMIT NUMBER
sA
04* *19.00
* 1 9.006
A *0.00
91212
09-16-83
2 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-16-83
DATE ISSUED
91222 *1.9.00ae
PERMIT NO. TOTAL.