1984, 03-15 Permit: 84A-2251 FurnacePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 04A
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1. S. 3205 Robbie
2.
Lor BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER PHONE PHONE
3 Northwest Homes
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
S. 1611 Veracrest Veradale Wa
99037
North South East
West
CONTI�4 TQRe
�{{ d f Furnace
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
1 1
Residential ❑
�Ljj n o r
3/2/85
928-8252
Commercial
4.
ADDRESS
E. 9311 Trent, Spokane
ZIP
99206
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE CXNEW 11 ALT. ❑ AD' N. El RPL. El MVE.
7. El OTHER
OF
WORK ❑ BLD. ❑ PLM B. E�MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No C]
8. DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
nurt k for 15 K W
Electric Furnace
Yes Not Applic. ❑
Received ❑
VALUATION
9•
I SOOURCE
GAS
ELECTRIC
XX
❑
pUB IC R
SEWAGE
SEPTIC El
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ 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
work will be complied with whether specified herein or not. The granting of a permit does not resume to
p p g g p p 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 APPLICATION
J. Arc her 3/14/84
20.00
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS
Env. Health
Planning
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
20.00
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
neT.Sc �icrL ' ocoftA1�k 5. 1 �
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