1983, 09-28 Permit: 83A-9641 Furnace, Heat PumpPLAN NUMBER IICAT ION /PERMIT PERMIT NUMBER
IAPPL
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY (4-(
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
OWNER
PHONE
PHONE
3. av e //
MAILING ADDRESS
ZIP
Actua Set Backs n Feet to:
North South East West
CONTRA R+
LICENSE EXPIRES
PHONE
Size of Parcel
ZoneClassification
Residential ❑
4.
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑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
Unf in. Basement
6.
v
TOFPE I�PtEW 11 ALT. El AWN. El RPL. El MVE.7.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
❑OTHER
WORK ❑ BLD. ❑ PLMB. tVECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required Yes❑ No❑
Number
orVariance
Received Yes❑ No❑
DESCRIB WORI,V
_
8'5_&&'
Shorelines/Flood Hazard
Plans Required ❑
f,� fir ly j . f i� i- r
Yes ❑ Not Applic. ❑
Received ❑
VALUATION
SOUOOFC
GAS
EL CTRI 'j
[ - PURL C D
SEPTICD
Ownership
FEES COLLECTED
9•
UTILITIES
/
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
I hereby certify that I have read and examined his application and have read the "NOTICE" providlons 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 presume to give au-
Building
thority to violate or cancel the provisions of any other a or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQIJIRz6 INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE �%
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM.
FINAL
DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
Fire
MFG. Home
>
Prevent.
a
C
Engineer
Other (Specify)
L
IA
Utilities
�-� it
TOTAL $
U
SEPA
WHEN MACHINE VALIDATED IN
THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
Building
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED*19,000-j
9 B — ��
D J
* 19, G G ---
7 /% 1
Tech.
tffv
IN 180 DAYS
t, — - 5
z
DATE ISSUED PERMIT
NO. TOTAL