1983, 03-25 Permit: 83A-2230 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
STREET ADDRESS
1.
• VSA/ 5 -
PARCEL NO.
LOT
2.
BLOCK 1 SUBDIVISION
LEGAL DESCRIPTION:
OWNER
3 %%% tz. LA -2k Iii2JU
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
E. V//,s- 9 , _ North 'South
4.
5.
CO TRACT R
0./ . 1' ( /f A•
PHONE PHONE
S'3V-Je/62
LICENSE EXPIRES
7-9-8.3
PHONE
ADDZIP
DESIGNER PHONE
ADDRESS
/SQyLE f c.
CHANGE OF USE FROM
6.
Size of Parcel
Est
Zone Classification
West
Type Const.
Occupancy
Residential 0
Commerclal
Sprinklered
❑Yes ❑No ❑Req'd.
ZIP
TO
TYPE ❑ NEW ❑ ALT. O AD' N.
7. OF
WORK O BLD.
0 PLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Upper F Dors
Garage/Storage
Greenhouse
(over Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Bath*
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No
Number
DESCRIBE
PUBLIC8.
Shorelines/ Flood Hazard
Yes❑ Not Applic. ❑
VALUATION
9. /5/35! o
SOURCE GAS
UTILITIES
ELECTRIC
WATER
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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 OFAPPLICATION
OWNER OR AGENT _ s 02@,,-.c.ti `e DATE .3 -a2 $4-e3
SPECIAL APPROVALS SPECIAL CONDITIONS(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required O
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ /6- a O
PERMIT NUMBER
PM- 2---30
04* *1600
*16006
A *Q00
22292
03-25-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED -
PERMIT f22 ; 0 Z
* 16, 0 °ri*