1983, 12-19 Permit: 83B-2630 Mechanical FixturesPLAIN NUMOMM I #kr-r-L1%oJ 1 1 IVIV / r'C.KM
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
STREET ADDRESS
PARCEL NO.
1• N. 502 Lon
Fin. Basement Unfin. Basement
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
TYPE
I
Floors
OWNER
PHONE
PHONE
3 Forrest L
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
N. 502 Long Greenaores WA
99016
North South East West
CONTRACTOR LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
Valley Fireplace 1A/84
4.
922_
VALUATION
SOURCE
OF
Commercial ❑
ADDRESS
ZIP
Type Const.
Oxupancy
Sprinklered
Sprague E. 16610 ra Ue Ave. Veradale WA
99037
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor area
5 Contr. License ALL F-177CG
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basement
6.
Modular/
MFG. Home
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
;eNEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE.
7 WORK ❑ BLD. ❑ PLMB.X1MECH. ❑ M.H. ❑ POOL OF ❑OTHER
Certifi.ofExempt. _T
Required Yes❑ No❑
Number
or Variance
Received Yes ❑ No ❑
DESCRIBE WORK Installation of Earth Stove I sert,
8.
Shorelines/Flood Hazard
Plans Required ❑
TModel No. n� (�
Yes Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ECTRIC
AER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
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 REVERSE IDE FOR REOUI ED INSPECTIONS
SIGNATURE OF ' APPLICATION c
OWNER OR AGENT t o I' ;/ DATE E -s
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SI
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent. F1
Utilities
Plans I 1 1 1 PERMIT IS NONTRANSFERABLE
Exam. 1 14,,PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. i 1z
Building
Plumbing
Mech.
%�.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN T
THIS BECOMES A PERMIT.
F'LHMII NUMBEH
✓31 - 74,,,�o
DATE4SiUED-' ' PERMITiJO. FUfAL
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