1983, 12-08 Permit: 83B-2392 FurnacePLAN NUMBER APPL ICAT ION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPI,.ETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREETADDRESS ' PARCEL NP.
2. LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER ii ; % /�' " PFMNE _ PHONE
3. f-11
�
MAILINC, ADDF ESS
Z �'
Actual Set Backs in Feet to:
}
J( _
North South East
West
C TRACTOR
LIC NSEEXPI S
P O �jC/'
Size of Parcel
Zone Classification
Residential
4.
Commercial ❑
AD
13
ZI (�
I r
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TYPE , NEW
❑ALT. El AD' N. ❑RPL. El MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF
❑OTHER
WORK El BLD.
❑ PLMB. 1:1MECH. ElM.H. El POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
8 DESCRIBE WOR
-
Shorelines/ Flood Hazard
Plans Required ❑
/L- jL
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9•
SOO
UFCE GAS
ELECTRIC I
PUBLIC ❑
SEPTIC SEWAGE
OwnershipF
—
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER DI
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 compli dWith
whether specified herein or not. The granting of a permit does not presume to give au-
Building
thority to violate or ca
cel the provisis of any other ate or local law regulating construction or the performance
of construction. SE
EVERSE SIDE OR REQUIR15DANSPECTIONS
Plumbing
SIGNATURE OF
APPLICATION /� -7 o
Z
OWNER ORA
DATE (
Mach. I !
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
fr1 _ /� '}`
L �,� o� U �,�
Plan Check
Env. Health
+
j , J�
<�
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building! 7/i6
j I N 180 DAYS
Tech.
Other (Specify)
TOTAL $
PERMITNUMBER 22
Z
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I2-08-03 23'9.2z
DATE ISSUED PERMIT NO.
9.
*19,00°r
TOTAL
CL
O
V
W
J
U-