1983, 10-26 Permit: 83B-906 FurnacePLAN NUMBER
APPLICATION/PERMIT
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
STREETADDRESS PARCEL NO.
1• 1117 Mica Park
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER PHONE PHONE
3. Landreth Cont.
MAILING AD RESS ��ZIP
S. 02 Shoreline Dr.,9X Libe ty Lake
CONTRACTOR LICENSE EXPIRES PHONEYYU
4. e rf F 4 2 -
ADDRESS ZIP
E. 9311 Trent, Spokane, Wn. 99206
DESIGNER PHONE
5.
ADDRESS ZIP
North I South
Type Const. Occupancy
New Const. Valuation,_7
Main Floor I Upper Floors
East I West
coneuassmcation I Residential ❑
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'd.
ed Valuation Total Bldg. Floor Area
Garage/Storage I Greenhouse
CHANGE OF USE FROM I TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
s.
TYPE No. Baths No. Floors No. Fin. Rooms No. Dwellings
7. OF � NEW ❑ALT. ❑ AD'N. ❑RPL. ❑ MVE. ❑OTHER
WORK ❑ BLD. ❑ PLMB. XMECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number
or Variance Received Yes El No 1-1
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required ❑
8• 1- 15KW Electric Furnace I Yes❑ Not Applic. ❑ Received ❑
VALUATION I SOURCE GAS ELECTRIC WATER I SEWAGE I Ownership
9 OF PUBLIC ❑ SEPTIC 1-1FEES❑Private ❑ FEES COLLECTED
UTILITIES XX�C PRIVATE 1-1SEWER El
I hereby certify that 1 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 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 Plumbing
SIGNATURE OFAhAPPLICATION
J. Archer OWNER OR AGENT DATE 10/25/83 Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
14.00
PERMIT NUMBER
Engineer Other (Specify)
Utilities 14 .
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYSii 8 3
Tech. xW DATE7S�UEl� PERMIT NB. O, 6 c * 1 4 ii n SAL
O
C
C
U
U