1983, 09-16 Permit: 83A-9127 Boiler PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER '
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY `&M -91 i,1
CNORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PA RPA R
1. /f2-/9 P."?. . �
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWN PH7- /`Y PHONE
3.
C. �/� `psi 1f= (�L
MAILING ADDRESS /J est ZIP/, Actual Set Backs in Feet to:
/ /.2•4•c? , /.� y/ y— 7>.2i; North 'South East I West
CONTRACTOR LICENSEEXPIR PHONE Size of Parcel Zone Classification Residential
4. BANNER FURNACE & FUEL. INC. C --/--4' _ 535 1711 Commercial❑
ADW.E921. BOX 4346 ZIP 99202 Type Const. Occupancy ❑Yes Spr❑Nored ❑Req'd.
- t_ 4 * ' 1 (-) 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
* 1 700
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - I * 3 (' 0) 7
c
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement w' 12, 6 —
r.(1(
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. iPL. El MVE. -- 4 4
7 r7 WORK El BLD. ❑ PLMB.kMECH. ❑ M.H. El POOL CI OTHER Certifi.of Exempt. Required Yes No Number
or Variance Received Yes No❑
Required 0
8. D p, ��� "/L Ne/�, ` �2,//Y / 2 6 /� SYh�or❑elinesNolood t Hazc.ard Plans Received ❑ i
VALUATION/t�/ SOURCEGGAS ELECTRICv WATER _-,, ...;,20,_/,,:z
+' SEWAGE Ownership ,FEES COLLECTED
9. PUBLIC ID SEPTIC❑
PRIVATE 1=1 SEWER C Public❑Private ElUTILILITIES
__ A
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 REVE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OFAPPLICATION • 4 --�-�
OWNER OR AGENT , "4‘-',/,,,, r-e7Mech.DATE /7,6,z,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE } Plan Check
Env.Health / tZ'�fiX721
SEPA
Planning
Modular/ ,
MFG.Home
Fire
fa-
Prevent.
O y
Other(Specify) v
Engineer ty
J_
Utilities / / e L.
TOTAL $ �7
SEPA
WEN MACHINE
Plans PERMIT IS NONTRANSFERABLE HHS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED •
•
Tec \Building 74, IN 180 DAYS JJ 6 -8 3 9 2.7 z•- * 1 7.0 0 °
DATETSSUED PERMIT NO. TOTAL