1984, 02-24 Permit: 84A-1580 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPAaTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. E. 10722 Maxwell
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3
4.
5.
,OWNER Anderson
ME -4399
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
E. 10722 Maxwell
ZIP
99206
Actual Set Backs in Feet to.
North ISouth
East
West
CONTRACTOR
STIi'2iv1 1 -3.1 -
ADDRESS ADDRESS
E. 204 Indiana
LICENSE EXPIRES
11/6/Rd
PHONE
325-4505
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ZI P
99207
Type Const.
Occupancy
Spr'nklered
CVes CNo CReq'd.
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
Unfin. Basement
TYPE ® NEW ❑ ALT. ❑ AD' N. 0 RPL. ❑ MVE.
7• OF ❑ BLD. 0 PLMB. %I MECH. ❑ M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certlfi. of Exempt.
or Variance
Required YesD Non
Received VesO No❑
Number
DESCRIBE WORK
8. Install .as furnace
Shorelines/Flood Hazard
YesO Not Apolic.0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
XX
ELECTRIC
WATER
PUBLIC 0
PRIVATE
SEWAGE
SEPTIC 0
SEWER n
Ownership
Public 0 Private 0
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 SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER (;R AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
2.
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION -7
/�'/ DATE v�
SPECIAL CONDITRONS:.jSEE REVERSE SIDE FOR NOTICE)
gas piping @ = $.2.00
permit= 10.00
under 100,000s2U6.00
-ly
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)
c -o.----
TOTAL
TOTAL $
PERMIT NUMBER
04* *2000
*2000
A *0.00 g
1 57.9
02-24-84
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02-24
DATE ISSUED l' PERMIT NO. TOTAL
158,0= *210021--1