1983, 08-24 Permit: 83A-8122 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 63A `0\--z2—
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS L). * * 1 U v
1.
,, / �� d - (‘Ni viitkj PARCEL NO.
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION: „
2. n * L .
OWNER f(�� ((�•� PHONE PHONE f" ,
TttoctMe, L-eal%S 415 G"5 ,' I I
3. MAILING ADDRESS ^� ZIP /� Actual Set Backs In Feet to: - L _
c,i) 31 !—/0� qq,6 L/ North 'South East I West
CONTRACTO c�,� / (� LICENSE/- EXP RES PHONEc -7 2 Size of Parcel Zone Classification Residential❑
cJU 112 t/2 e(L `,�L� 6"4 _4 35—<3 33 Commercial❑
4. ADDRESS r ,,/ 2��� /� ZIP , Type Const. Occupancy Sprinklered
t .7x361 f S.�/lid (19C O ❑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. _
TYPENo.Baths No.Floors No.Fin.Rooms No.Dwellings
NEW ❑ ALT. ❑ AD'N. ❑ RPL. D MVE.
7. OF ❑ OTHER
Li BLD. ❑ PLMB. ❑ MECH. E M.H. 0 POOL Certifi.of Exempt. Required Yes No❑ Number
WORK or Variance Received Yes Non
DESCRIaE WORK �/ Shorelines/Flood Hazard Plans Required El
8. Sy' , /U4 O Q��/U 6. ' cd(/7OC( Yes Not Applic.❑ Received El
VALUATION SOURCE GA ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. UTILITIES PUBLIC❑ SEPTIC❑ public CI Private❑
PRIVATE❑ SEWER❑
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 SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF 1) 4- APPLICATION_,Sis-g`3
OWNER OR AGENT DATE c7` Mech.
•
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health `
W / / f t SEPAPlanningU(', [/1 Fa.,(9
Modular/
�! MFG.Home
Fire a
Prevent.
O s
C.)
Engineer Other(Specify) U.I
J_
Utilities '1'1
TOTAL $ J O "U
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
Budding1)d i/LIN 180 DAYS lo 4
nQ
E 4 8
OOoi
Tech. DATEfS.l PERMITN
TOTAL