1983, 12-13 Permit: 83B-2483 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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 PARCEL NO.
1. C /4/ 3/9 .i. c
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNERPHONE PHONE
3/ ' /l c..1' .�:e0
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
�QK.t -e North 'South East (West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial❑ r
ADDRESS , ZIP Type Const. Occupancy Sprinklered
— j'Z.y _..1.:,-<. /V/.$'-� 992- / ❑Yes ❑No ❑Req'd. *• I ` 0 0
-
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5 ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse i (! .
a•
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement _ .1 -
6. ' '1
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. s
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes Nor]
DESCRIBEFORK . Shorelines/Flood Hazard Plans Required 0
8. T scS� //i ce e/C. �ac.%. — Z-e%IZcGG Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC/ WATER SEWA Ownership FEES COLLECTED
9• UTILLIITIES -a-.-.7PRIVATE❑ SEPTIC O
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
O
SIGNATURE OF N�.� Z.' {' DAPLICATION�� , 3 -1. yv
OWNER OR AGE r /' .S' 12 DATE Mech. /l '
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
he proviif Modular/
MFG.Home
Fire � /1 d
Prevent. 40 O
U
Engineer Other(Specify) to
J_
Utilities /� Oo LT-
TOTAL
-
TOTAL $ -'—= I\
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 •
i
Building IN 180 DAYS DATE E . PERMIT4I�'. �° n tDDrAL
s —DL 3 — .- 8° 1