HomeMy WebLinkAbout1983, 09-30 Permit: 83A-9774 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 1 (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. E 6.2 12_ I is Li
LOT SUBDIVISION
2.
BLOCK
OWNER
�'
. l<
MAILING ADDRESS
PARCEL NO.
r �u
PHONE p,cc,
12 i - &=i(^
P't-IONE
LEGAL DESCRIPTION:
CONTRACTOR
1LE. TctLjV 144, r
4. ADDRESS
/V3.Y0i' ��"L/"1 XD. fly 3
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
LICENSE EXPIRES
1 ? `f -
PHONE
ILL 5 32%
Actual Set Backs in Feet to:
Nth 'South East 1 West
Size of Parcel Zone Classification
Residential C
Commercial C
ZIP
j'4zi k
Type Const.
Occupancy
Sprinklered
CYes ❑No EReq'd.
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. ❑ AD' N. RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. pMECH. E M.H. ❑ POOL
8. L i 9 f Q C 0 5T&- C3 IAS 'EA V\ c"{.
VALUATION l SO DURCE WATER
UTILITIES PUBLIC C
PRIVATE E
DESCRIBE WORK
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesC No❑
Received YesE No
Number
9.
GAS f ELECTRIC
Shorelines/Flood Hazard
YesE Not Applic. C
Plans Required E
Received C
SEWAGE
SEPTIC C
SEWER C
Ownership
Public C Private E
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 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 REVERpE,SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF APPLICATION c �, j --,
OWNER OR AGENT /4-0.4%" / L DATE > >
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
O)(3
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
I N 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
cl7 7
CL
O
W
J_
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IS$ 0. 7
PERMIT O.r 7' z
*10.Uua -
TOTAL