1983, 01-11 Permit: 83A-0221 Furnace, Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY e'.5A ' o _ I
C NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. HiQ j 1
3. OWfr_ I Gi, y'/_ s ,314,'0 PHONE
MA�NG AIM E S 4\441.11...... /"_ ✓ f 7y �� GActual Set Backs in Feet
Norruth LEast (West
CONTRACTp��j LLICENSE EXPIRES `✓�i� [' Size of Parcel I Zone Classification Residential❑
'1 c? !� G� •l�"� Commercial❑
4. AD ESS �� Type Const. Occupancy Sprinklered
32..� 6,5„1,,,,L___ ❑Yes ❑No ❑Raga.
DESIGNER
79-2,0..7
NE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. - * i L (; 0
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse 1.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6. t_ L' ,
No.Baths No.Floors No.Fin.Rooms No.Dwellings 1 -- 'j 1 —
TYPE ❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
7. OF 0 OTHER r l'
WORK ❑ BLD. 0 PLMB. ❑ MECH. El M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ NoD Number
or Variance Received Yes No❑
DESCWRKh Irc Ni I 0 Nicl Shorelines/Flood Hazard Plans Required❑
8. Jrii"t Yes❑ Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC WATPUBLIEO SEPTIC❑R SEWAE Ownership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public❑Private❑
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 grantingof apermit does notpresume to Building
p p 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 , � APPLICATION ///03q
OWNER OR AGENT 8� DATE Mech. �'—
SPECIAL APPROVALS SPE�ONDI ONS: SEE REVS E SIDE FOR NOTICE •
Env.Health PRELIM. FINAL DATE rJ I�t� /C�.�•M 13-•rJ - /,- O c] ) Plan Check
I I eI l�7 or- `11 i l O ° SEPAPlanningI`VI ( crn'
--_
Modular/
Fire t(�' �j�i/1 i 'r --- �- v� MFG.Home >-
Prevent. d
O
Engineer Other(Specify) v
W
J_
Utilities 1.5 - LL'
. TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Pxam
[ PERMIT IS NULL AND VOID IF WORK IN 1 0 DAYS HAS NOT COMMENCED O , •
1 1 -8 3 2•
21 z *1 8, 0
Building �
Tech. f DATE 1 UED PERMIT NO. . TOTAL