1983, 11-29 Permit: 83B-2090 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY t —1c270
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS- , f/7 / /d1 a� PARCEL NO
1 of ,2
LOT BLOCK SUBDIVISION 1 LEGAL DESCRIPTION:
2.
OWNERPHONE PHONE
3. y d 0 Mei1 r h 6717_ I99I
MAILING ADDRESS ZIPActual Set Backs in Feet to:
09'1-67. North 'South East I West
CONTRACTOR LICENSE EXPIRES PHQNE Size of Parcel Zone Classification Residential❑
11 e",1 "et'/ /K/ ii Z d������ Commercial❑
4. ADDRESS
l6 fie J . ,, ZIff 'G� Type Const. Occupancy ❑Yes Spr❑Noinkler� ❑Req'd.
DESIGNER / PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
FJ. 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 ❑ NEW )SALT. ❑ AD'N. ❑ RPL. ID MVE.
7. OFD OTHER .
WORK ❑ BLD. ❑ PLMB. t' ,MECH. ❑ M.H. El POOL Certridaof Exempt. Required Yes No❑ Number
or Received Yes❑ No IO
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS • ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF PUBLIC❑ SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private❑
UTILITIES
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 DE FOR REQUIRED INSPECTIONS Plumbing
OWNER
OF 'v"`� DATEAPPLICATION j/_,7-1,-_,
Mech. ,
OWNER OR AGENT — `
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE ^
Env.Health y" �'
JJJ SEPA
Planning ,n�J
/Q� �a /I� Modular/
1 {�+ f! MFG.Home >
Fire ):) I If
1 I V" O.
1 O.
Prevent.
C.1
Engineer Other(Specify) W
9 J
IT
Utilities 18
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. 1 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding i( IN 180 DAYS l 1 9 n
Tech. /Z1 DATEISSUE� _ PERMl2N l.9. 0 z * 1 8. 0 0 iY AL