1983, 04-06 Permit: 83A-2703 FurnacePLAN 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
1
STREET ADDRESS
• L7C '(v 1h{ oc:;
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3
4.
5.
OWNER
L.Y01�^wCiN INCr�i
MAILING ADDRESS
44-
CONTRACTOR
4£.AiT
ADDRESS
1J . 14( --
DESIGNER
PHONE
PHONE
Cts-ra%
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North !South
LICENSE EXPIRES
PHONE
yt�t`..t_
Size of Parcel
East 1 West
Zone Classification
ZIP
C&Cc 1—O 7
Type Const.
Occupancy
Residential
Commercial Li
Sprinklered
Yes LI No ❑ Req 'd.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE Q'NEW ❑ ALT. ❑ ' N. ❑ RPL. ❑ MVE.
7. OF BLD. ❑ PLMB. BMECH. O M.H. O POOL
WORK
❑ OTHER
Main Floor
Upper Floors
Garage/Storage Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No7 Number
Received YesC No
DESCRIBE WORK
TL. l C?� (-
VALUATION VALUATION
9.
Shorelines/Flood Hazard
Yes C Not Applic.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE C
SEWAGE
SEPTIC E
SEWER C
Ownership
Public O Private C
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
SIGNATURE OF APPLICATION /�
OWNER OR AGENT i` /n►i DATE/` �3
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fre
Prevent.
Engineer
Utilities
"SEPA
Plans
Exam.
Building
Tech.
ECIAL • NDITIONS: (SEE REVERSE SIDE FOR NOTICE)
ed- /Wit '
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received E
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
1 PERMIT NUMBER
34 271)3
u4* *19.00
* 1 9,006
A *000
270,2
04-06-83
-3 6479.
WHEN MACHINE VALIDATED IN THIS SPAC
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO. TOTAL
,._P ►,►•til.• 9'7(39 *l9.0fl°