1983, 10-03 Permit: 83A-9866 Furnace, PipingPLAN NUMBER
APPLICATION /PERMIT
PERMIT NxMBER
CDNTRACTOR
LI ENSEEXPI S
SPOKANE COUNTY DEPAR VT
Size of Parcel
Zone Classification
Residential ❑
— i ME OF BUILDING & SAFETY
AT%z'/iN5 = , v'
4.
A
;�qz; —/,P,? -3
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
Commercial ❑
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
RESS
�.. //6/6
STREETADDRESS�
1. /
/,4/,-
PARCEL NO.
Sprinklered
❑Yes ❑No ❑Req'd.
lj. a7.94
t, Ile U ,
New Const. Valuation
Remodeled Valuation
2. LOT
I BLOCK
I SUBDIVISION
LEGAL DESCRIPTION:
OWNER
�j,q, = T-�/o � _5
PHONE
PHONE
3.
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
`` zj %77 e
Unfin. Basement
s.
1_6�,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. I N 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
`p
TOTAL $ �-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
u6
DATE ISSUED PERMIT NO.
00'
TOTAL
D
C
C.
U
U
North South East I West
CDNTRACTOR
LI ENSEEXPI S
PHONE
Size of Parcel
Zone Classification
Residential ❑
AT%z'/iN5 = , v'
4.
A
;�qz; —/,P,? -3
Commercial ❑
RESS
�.. //6/6
ZIP
U4�
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
F
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Deck
Fin. Basement
Unfin. Basement
s.
1_6�,
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE E3 NEW 13 ALT. El AWN. El RPL. 11 MVE.
7 ❑OTHER
Certifi.ofExempt .
Required Yes❑ No❑
Number
WORK El BLD. ❑ PLMB.)MECH. ElM.H. El POOL
or Variance
Received Yes❑ No❑
D CRIBE WORK QJF%/�/
8.
Shorelines/ Flood Hazard
Plans Required ❑
7�
DOO / C! LC/rLtr.�2 L �fi/ (�¢
__[ELECTRIC
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9
I SOURCE
OF
G S
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ElSEWER
❑
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
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� . CATION � 3
��
OWNER OR AGENT _ DATEerr �
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. I N 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
`p
TOTAL $ �-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
u6
DATE ISSUED PERMIT NO.
00'
TOTAL
D
C
C.
U
U