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1984, 02-21 Permit: 84A-1388 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY eol.p, " v 3 NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 1. £. 771 z- 5-.. is y 4.., ►..3 E ••z , LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. OWNER PHONE PHONE i ._ MAILING ADDRESS ZIP Actual Set Backs in Feet to: . -7-71 Z `i iC`( L I.‘....)C .CI t �G North j South [East I West CONTRACTO-R-� LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0 -12-. L, +.i.``-A-4-'-v ( it c.-'F. '32t -C 7 Commercial 0 • 4' ADDRESS� � ZIP Type Const. Occupancy Sprinklered E " "7,I( iJ . C_. .©A+Ga._ ca c-t cC`a ---* ❑Yes 0 N ❑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 Unf in.Basement 6. No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE 0 NEW 0 ALT. ❑),D'N. 0 RPL. 0 MVE. 7 WORK 0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DESCRIBE WORK Shorelines/Flood Hazard Plans Required 0 8• � T-4...,(2_4,-1 p►LC — i,O Ct*G`#'�T (C:tA'AA]C.E- c">c.a T, Yes❑ Not Applic.0 Received ❑ VALUATION SOO URCE GAS 1 ELECTRIC PUBLIC WATER EW C❑ Ownership FEES COLLECTED 9UTILITIES PRIVATE CISEWER❑ Public 0 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 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 REV • E SIDE FOR • •DIRE 9 PECTIONS Plumbing SIGNATURE OF / APPLICATI e N OWNER OR AGEN - Amor DATE / Mech. '"CJ-C.z� SPECIAL APPRO/ALS; SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTI ) PRELIM. FINAL DATE Plan Check Env.Health _ SEPA Planning Modular/ Fire MFG.Home ) Prevent. a O Engineer Other(Specify) MI W J_ Utilities LL' _ TOTAL $ Ca. r. SEPA PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE, Plans THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building IN 180 DAYS n 8. 8-2 * 2O. 0 °To 4Tech. .7- 1, DATE IBSDE6 2 1 — 8 4 PERMIT t � L