1983, 03-11 Permit: 83A-1758 FireplacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. S . 4043 Schafer
•1PARt:EL NO.
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER Larry Benzin3er
PHONE
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
3. 4043 Schafer
ZIP
Actual Set Backs in Feet to:
North (South 'East West
4.
5.
CONTRACTOR
V- alley i 1rer'l.ac ), 1C.
LICENSE EXPIRES
f`'!
PHONE Size of Parcel
922-278A
Zone Classification
Residential ..0
Commercial 0
ADDRESS
L. 1E7610 Sprague Ave.
DESIGNER `erudale, WA.
ontr License 7i' VALLFF-S26LT
9'9037
Type Const.
Occupancy
Spr'nklered
❑Yes No ❑Req'd.
PHONE
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ BLD. 0 PLMB. ❑ MECH. 0 M.H. ❑ POOL
WORK
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No0
Received Yes Ill Nof
Number
DESCRIBE WORK
8. •:ai tf
VALUATION
9.
tailed ISE'' Kine '_replace Furnace
nnr f'4_ran1 arF:
SOURCE GAS
UTILITIES
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Shorelines/Flood Hazard
Yes ❑ NotApplic. E
IOwnership
Public ❑ Private ❑
Plans Required ❑
Received ❑
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 REVERSE SIDE FOR REQUIRED INSPECTIONS y;
SIGNATURE OF
OWNER OR AGENT
APPLICATION 3- r}'
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.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER _
€7-3A (75 °
FILE COPY
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03-1'1:83
DATE ISSUED
]_5.82
*20,00a1 -
PERMIT NO. TOTAL