1983, 08-31 Permit: 83A-8427 Furnace PLAN NUMBER APPLICATION/PERMIT _ PERMIT VUMBER
_ SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY c -0+2- l
(z NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
/�/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS NO.
jf i
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 4K * I ? 0C
OWN PHONE PHONE * .� r
3. x--.67 ® /0rt, ',
MAILING ADDRESS ZIP Actual Set Backs in Feet to: r x
...X;K.., e- North 'South East I West
CONTR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ N 4 t_
4. OR�G--(...-- 32.G-(` e Commercial❑
ADDRESS ZIP—�L / Type Const. Occupancy ❑Yes Sprinklered ❑Req'd. r
Jaz`/ ��/, rrX ,
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
J. 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 El ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF El OTHER _
WORK ❑ BLD. ❑ PLMB..1 ,ECH. ❑ M.H. 17 POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes Non
DESCRIBE WORK, • //n Shorelines/Flood Hazard Plans Required❑
8• f. Gt 4 4.4...-- G', J ,<:".1,,,„1.. e. 0 Yes❑ Not Applic.LI Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 UTILITOFIES PUBLIC❑ SEPTIC❑
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 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 ✓ f APPLICATION 1L?_� ?
OWNER OR AG dG ly` DATE J Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATEPlan Check
Env.Health _ C/"CAj�q1" (- 1)>/•.C2;S
44 / ! ,�C� /C20 � �)
�1o`- !1t7 SEPA
Planning Modular/
Fire MFG.Home d
Prevent. O
Engineer Other(Specify) W
J_
V/J'
Utilities oe
TOTAL $ YY
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building Pr
y� IN 180 DAYS O 8 - 31 -8 3 �,,� 2, z * 18, 0 0 QcyrAL
Tech. y DATE ISSUED PERMI