1983, 11-30 Permit: 83B-2158 FurnacePLAN NUMBER APPL ICAT ION /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
1 STR AD RESS . w PARCEL NO. J
J&
2 IGT BL CK SUBDIVISION LEGAL DESCRIPTION:
SPECIAL APPROV
PRELIM. FINAI
Env. Health
Planning
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPEMAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
PE MIT NUMBER
y0*56
SEPA
P ONE / /
~ (GY 1610
PHONE
MFG. Home
JER
Other (Specify)
TOTAL $
N3./GU DRE
�JActual
6o
Set Backs in Feet to:
0
South East
West
VC
North
C
LICE S I
P E
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
JU
Type Const. Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
Pi—p-
Main Floor Upper
Floors
Garage/ Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
LLPL.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE 11 NEW ❑ALT. ❑ AD'N. "P 11 MVE.
7.
OF ��.. // ❑ OTHER
WORK El BLD. ❑ PLMB. q�IVIECH. ❑ M.H. ❑POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DE8.02SCRIBE WORK /
Shorelines/ Flood Hazard
Plans Required ❑
8.
Yes❑ NotApplic. ❑
Received ❑
9
VALUA ION
[7�
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
public ❑ Private ❑
FEES COLLECTED
t
UTILITIES
PRIVATE ❑
SEWER 1:1
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 compiled 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 REVEM SIDE FOR REQUI ED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION / `7 6`3
OWNER OR AGENT DATE
Lst
Mach.
SPECIAL APPROV
PRELIM. FINAI
Env. Health
Planning
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPEMAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
PE MIT NUMBER
y0*56
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SP
THIS BECOMES A PERMIT.
11-30-r; 215,8° *16,001
DATE ISSUED PERMIT NO. TOTAL
c
C
C
L
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