1984, 02-14 Permit: 84A-1246 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.
STREET ADDRESS //
BL
9 /i vA,7 . /J•Lt'
BL K SUBDIVIS ON
LOT
2.
OWNER
6— Ary
MAILING ADDRESS
PHONE
SIM?
PARCEL NO.
PHONE
ZIP
CONTTB*CTOR JJ))• LIC SE EXP( S
/ ''r Uhf/e/tel%
4. ADDRESS c----•
DESIGNER
5.
;A9a96
ZIP
9)ge7
HONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South [East I West
Size of Parcel
Zone Classification
Residential C
Commercial 0
Type Const.
Occupancy
Sp nklered
Oyes DNo ORe4'd.
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
Un v. Deck
Fin. Basement
Untln. Basement
TYPE ,`W 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
! OF 0 BLD. 0 PLMB. W MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certiti. of Exempt.
or Variance
Required VesO No0
Received YesD No0
Number
DESC BEyVOR�c /
7/217W' thildg//L�Y�7 ;w 4/I 6'
VALUATION SO RCE I GAS EL T PUBLIC O
9. UTILITIES PRIVATE 0
Shorelines/Flood Haze d
YesD Not Applic.0
Plans Required 0
Received 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public O 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 9r not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any er state or local law regulating construction or the performance
of construction. SEE REVERSE SpE FOR R I6ED INSPECTIONS
SIGNATURE OF �! /� APPLICATION ,J
OWNER OR AGENT /DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIpNS: (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 $
caggi)
PERMIT NUMBER
eTha -1Q%
04* *2Q50
*20.506
A *0.00 0
1211.42
02-14-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4 DATE latkr 114 f8 4
PERMIT NO. 2 * 0' 5.0 TOTAL: