1984, 02-22 Permit: 84A-1447 FurnacePLAN NUMBER
APPLICATION,/PERMIT
SPOKANE COUNTY - DEPARTI( 'NT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANI, W,AHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. h CQ2D E. IAO(K
LOT I BLOCK
2.
SUBDIVISION
PARCEL NO.
OWNER
3 AL. r H -Y Ko
MAILING ADDRESS
PHONE
HONE
z8-g37o
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North ISouth East I West
4.
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Spr nklered
Dees 0 N OReq'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Untln. Basement
TYPE ANEW
7. OF
WORK 0 BLD.
8.
DESCRIBE WORK
0 ALT. 0 AD' N. 0 RPL. 0 MVE.
❑ PLMB. p(MECH. 0 M.H. 0 POOL
0 OTHER
REPLa441 OF �, na\1PoJC-
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Gerbil. of Exempt.
or Variance
Required YesO No0
Received Yes0 No0
Number
Shorelines/Flood Hazard
VesO Not Aeolic. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
PC PC
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 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 pr ieqs of any other state or local law regulating construction or the performance
of construction. SEE REVER SIDE FOR REQUIRED SPEC ONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fre
Prevent.
Engineer
UtIlities
SEPA
Pans
Exam.
Building
Tech.
Z/Z/
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
I - £63(OEo BT -0 &M pt)MJ1
I - W AI - wviofr 4-
i--l�)Ct'l �&t2 % t -
2 -
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)
22. °.-
TOTAL $ 2'0I
PERMIT NUMBER
eiA—N47
04* *2200
1446
02-22-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQs6Uctr 122--' 8,4'
PERMITINq.4. 7':Z
*2'2,00aOOAL