1983, 10-07 Permit: 83B-121 Furnace, Heat Pump PLAN NUMBER APPLICATION/PERMIT x19 PEWIT NUMBER I�
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY �3 1.� e3r3 lz f
0 NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
PARC NO7 -
1. /97,U • ' 4. Af}e,I/
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER / PHONE PHONE
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
-�� vtc.. North 'South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. ./+{-''/ - 'Z6"�+fa'e". Commercial 0
ADDRESS J� '/ ZIP Type Const. Occupancy Sprinklered
z 7 .—# —1 9 2_0/ ❑Yes ❑No ❑Req'd. '
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area * ( j
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
I
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
❑ OTHER
WORK DIBLD. ❑ PLMB. ElMECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Vest: No❑ Number
or Variance Received Yes No
DESCRIBE WOR — A Shorelines/Flood Hazard Plans Required 0
8 /
z$ G 'c,S ✓ c-e_ ea,,,t ` Ag`, i�, ` Yes Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC 0 SEPTIC 0
PRIVATE 0 SEWER❑ Public 0 Private 0
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 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 OF ,./ e0"4/14;74,1-
/ e0v � APPLICATION .� �/
OWNER OR AGENT `r Q � � DATE yQ 'd 3 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health CUZa
fr-L1t 614'-'1'-'1Z: /C-..).Ai C SEPA
Planning -?,*11/C)JD rl c7 Modular/
may/ y t MFG.Home >-
Prevent. —1 7�'�ftLy �,1�/�/�f C
Other(Specify) v
Engineer IW
J
Utilities _ oat LCL
TOTAL $ Zy
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /j IN 180 DAYS 1_0 -0 7 -8 5 ry oO
Tech. 7 SS 2, l z * 2 L�. 0 910Y
AL I UED PERMIT N 7DTAL