1983, 09-29 Permit: 83A-9686 FurnacePLAN NUMBER APPL MCAT ION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
WORK
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
Received Yes[--] No❑
STREErADDRESS
c
6e-
PARCEL NO.
Yes Not Applic. ❑
Received ❑
LOT
BLOCK
SUBDIVISION
ELECTRIC
PUBLIC O
LEGAL DESCRIPTION:
U"nership
2.
FEES COLLECTED
UTILITIES/[`
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
OWNER
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
PHONE
PHONE
Building
work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au-
ff
_ J
/ r/
—6
Plumbing
SIGNATURE OF i APPLICATION
C7
3
�l
P
1
PRELIM. FINAL DATE
Plan Check
Env. Health
MAILING ADDRESS
ZIP
Actual Set Backs In Feet to:
C'
SEPA
Modular)
Planning
North South East West
CONTRACTOp /
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Se vl
& .. _ >
q
Prevent.
- _ 7 -
Commercial ❑
4.
Enaineer
.. _�
ADDRESS. —
ZIP,,
Type Const. Occupancy Sprinklered
/
LTui.; 41 �I O�
f 7c�t �—.
Dyes ❑No
❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESSZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE El NEW C3 ALT. 11 AD' N.
11 RPL.
❑ MVE.
7•
OF❑
❑OTHER
BLD. ElPLMB. ❑ MECH.
ElM.H.
El POOL
Certifi. of Exempt.
Required Yes❑ No❑
Number
WORK
or Variance
Received Yes[--] No❑
DESCRIBE WORK
8• �L� '
Shorelines/Flood Hazard
Plans Required ❑
�,�y
r i l t C
Yes Not Applic. ❑
Received ❑
VALUATION
9•
SOOUF
GAS
ELECTRIC
PUBLIC O
SEPT C El I SEWAGE
U"nership
FEES COLLECTED
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
Building
work will be compiled 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
Plumbing
SIGNATURE OF i APPLICATION
C7
OWNER OR AGENT ' L (� DATE r1
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
�I
�j CI
l_
SEPA
Modular)
Planning
MFG. Home
Fire
Prevent.
('� _
Other (Specify)
Enaineer
Utilities
Plans I I I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. 7
PERMIT NUMBER
/C,&
i r)cA
CSI c t,
v+>
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE
THIS BECOMES A PERMIT.
u9=L9-; 968.62
DATE ISSUED PERMIT NO.
18.O0a-�J-
T TAL
4
C
C
u
U