1983, 11-03 Permit: 83B-1265 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY " . `2.4,=S
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
ask
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
4
STREET ADDRESS PARCEL NO.
1. E. 5009 - 8th
LOT BLOCK SUBDIVISION LEGAL DESCr'PTION:
2. ,.■.,
•
OWNER PHONE PHONE
Ron Brady 534-1826
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
k;. 5009 - 8th Spokane, W 99206 North 'South East `West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
„, Valley Fireplace 1/1/84 922-2780 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
E. 16610 Sprague Ave. Veradale, WA 99037 ❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area -
5 Contr. License 4iVALLr'F-177CG
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
El OTHER
WORK ❑ BLD. ❑ PLMB. IDMECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No Number
or Variance Received Yes No I:1
DESCRIBE WORK Shorelines/Flood Hazard Plans Required 0
8. Installation of Convector Insert into existin unit. Yes Not Applic.0 Received 0
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. PUBLIC El SEPTIC❑
PRIVATE 0 SEWER❑ Public 0 Private 0
UTILILITIES
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 REVERS,E,SI9 FOR REOUI ED INS!ECTION� / Plumbing
SIGNATURE OF I ., APPLICATION ? 7 !7
OWNER OR AGENT Z 111 44,+^-(- DATE ?�� Mech. Ls"
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home
Fire a
Prevent. p
Engineer Other(Specify) W
Utilities
2-'0 LL..-
TOTAL $
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
ing it/ IN 180 DAYS 1 l E 3 11 L
DATE ISSUED �' PERMIT'N‘.6,5 a * 2 0, 0 0 i'04AL