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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°