1983, 03-11 Permit: 83A-1755 Furnace�mr4NUMBER APPLIICATION /PERMIT
-� I SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
/ ' O NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1. 1507 ':z. �:'•,_er .;,_
2. LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
OWNER-: 7��2"-257-,PHONE
3. .iC
MAILINQf.PF ESu
ZIP
Actual Set Backs in Feet to:
J �. . ii:ryr� ch
North South East
West
CONTRQC (0u1
TLt
LICEof IRES
.
Size of Parcel
Zone Classification
Residential ❑
4.
Commercial ❑
ADDRESSZIP
v. 1CCIC S-,)ra-ue '', fu•
999037
Type Const. Occupancy
Sprinklered
❑Yes ONO ❑Req'd.
DESIGNER 'y' ,yZ.aCU.1 +'i p .
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
ncv. Dec
Uk
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TOF YPE ❑NEW El ALT. ❑ AD'N. El RPL. El MVE.
7. 13 OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes NOD
Number
or Variance
Received
Yes ❑ No ❑
DESCRIBE wORKIn.stedlad <t7 3 b,— 1i " Ilryl c e
Shorelines/ Flood Hazard
Plans Required ❑
8' L . o ' 2.;,';2 r fir . Z ac. �-,.lsU rear Yrla1to.
Yes❑ NotApplic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
PUBLIC IC ❑
I
SEPTIC ❑
1
OwnershipT_
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
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 '
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Utilities
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REV E SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEEDp3 PERMITL . 5' 5 z
*OtAL
CL
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