1984, 03-29 Permit: 84A-2708 FurnacePLAN NUMBER APPL ICAT [ON./ 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.
/ -�o! 3
LOT I BLOCK I SUBDIVISION
2.
OWNER
3. al;�c _
MAILI ADDRESS
4. �r y
ADDRESS
DESIGNER
c
�. ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP /
�9 U to
LICENSE EXPIRES PHONE
n p
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ZIP
ZIP
PERMIT NUMBER
North South East I West
No. Baths
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
2 7'!: 8 * 2 1-il 0 0 OCL Fj
PERMIT NO. TOTAL
L
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
Env. Health
7. OF
El BLD. ElPLMB. �ECH. 1:1M.H. 11 POOL ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
WORK
or Variance
Received Yes❑ No❑
ESCRIBE WO�IK //yy
Shorelines/ Flood Hazard
Plans Required El8
t 7s� 0,:) �T �a?kJ
Yes[] Not Applic. ❑
Received ❑
VALUATION
SOU
GqS
ELECTRIC
PU ICO
TIC
SEPT SEP
owners
FEES COLLECTED
9•
UTILITIES
/�/
PRIVATE ❑
SEWER ❑
Public El 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
Engineer
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Utilities
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE REQUIRED INSPECTIONS
Plumbing
�SIDE
,�FOR
SIGNATURE OF APPLICATION ,,
OWNER OR AGENT ;fes- '�f`' DATE "' a 7'�
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
2 7'!: 8 * 2 1-il 0 0 OCL Fj
PERMIT NO. TOTAL
L
PRELIM.
FINAL
DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities
TOTAL $ cam=
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
_ /!
Building
Tech.
f
I
DATE fS�UED`//
2 7'!: 8 * 2 1-il 0 0 OCL Fj
PERMIT NO. TOTAL
L