1983, 08-10 Permit: 83A-7568 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 5-3A - 15(vS
C, NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES ( L, # ,r 1 Z;
STREET ADDRESS 7 c G t"► ` PARCEL NO.
1 LOT BLOCK SUBDIVISION -LEGAL DESCRIPTION: r; * i; (`
2.
OWNER", )_ P "NSE PHONE '5 6.7
3. 1:�� J)U u)d4 P/J, � yo16y 1S&
MAILING ADDRESS ZIP Actual Set Backs in Feet to: I U— 3
.5d-m 6. 99c?e•, 6 North 'South East I West ,: 611
CONTRACTOR/� LIC NSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. ''1 C eSCA/ ALE-p V, ` � X35-7333 Commercial❑
ADDRESS/-- ZJJ3� b� Type Const. Occupancy Sprinklered
C� . `f,}?�� /14/.5.-S
/6 i4 L7L ❑Yes OM ❑Req a.
DESIGNER /(/) !� PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 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 ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
El OTHER
WORK CIBLD. CIPLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No Number
or Variance Received Yes No❑
8 DESCRIBE WORK /' y / Shorelines/Flood Hazard Plans Required❑
/5 �6cj �/eL �t Cl urnac� uc �6 Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELEC�RIC WPUBER❑ SEPTIC G❑ Ownership FEES COLLECTED
9 OF fir(\ 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 APPLICATION
OWNER OR AGENT .. DATE � Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home >-
Fire
Prevent. d
O
Engineer
Other(Specify) V
W
J_
Utilities
/46° L_
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. t�/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED g
Building ing
Tech. I -. z/ IN 180 DAYS DATEIFSIIED1 0 -8 ) PERMIT716 6, 8 z * 1 4, 0 0 i-YL