1983, 06-10 Permit: 83A-5124 Furnace, Heat Pump PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANEZOUNTY — DEPARTMENT OF BUILDING & SAFETY 3A - 3 2A--
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON'99260/(509)456-3675
�.-- APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 5o . 3 g Z a./ .
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNE x. PHONE PHONE
cillaz
3.
MAILI ADDRESS ZIP Actual Set Backs in Feet to:
North 'South East I West
CONTRACT R LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
/� N , - ; Commercial❑ 0 Q * * 1 0 0
4. e
ADDRESS ZIP Type Const. Occupancy Sprinklered * 1 n 0 0 Y
G — ❑Yes ❑No ❑Req'd.
DESIGNER / PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area ri * 0 ;. i
5. 5 1 2 3:'
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
06- 1 C -03
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. 6u79
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE j-21 NEW ❑ ALT. ❑ AD'N. D RPL. ❑ MVE.
7. OF
❑ OTHER
WORK CIBLD. ❑ PLMB.)7 MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes Non Number
or Variance Received Yes❑ No❑
DESCRIBE WORK �:�J� �__ df-G pL f Shorelines/Flood Hazard Plans Required❑
8. � F�, : Yes❑ Not Applic.❑ Received ❑
VALUATION SOU E--
GAS ELECTRIC PUWATER BLIC SE Ownership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public❑Private 0
i
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
OWNER OR AGENT -4- • �% - DATE (i > Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
cm
Prevent.
O
Engineer M Other(Specify) v
W
J_
Utilities ,-
LL
' TOTAL $
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 z 5 1 q n �1
Budding e �` �� (.O IN 180 DAYS DATEOISSUED O — J PERMITNd.2.4 z *1 7. O U q'OITAL
Tech. \` �\`1