1983, 08-11 Permit: 83A 7640 Gas FurnacePLANNUMBER IAPPL ICAT ION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
/7 NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STRE DDRESS itZ PARCEL NO.
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
OWNER /J, �PHONE PHONE
3. -LLL 5'`i%7
MAILING ADDRESS
ZIP
Actual Set Backs In Feet to:
SPA
North South East
West
CONTRACTORI� �— 1
LICENSE EXPIRES
PHONE `/�
Size of Parcel
Zone Classification
Residential
Iz if—CC,iI•l�i
C ��
�''7
%J
$ �-
Commercial ❑
�.fJ�
4.
A_JDDRESS, �}
l � C�vL7
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
l!v� .7 o5 �lX; .
OG
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
per Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE 13 NEW El ALT. ElAD' N. ❑ RPL. ElMVE.
%. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB. "ECH. ❑ M.H. El POOL
Certlfi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK J
8.
Shorelines/ Flood Hazard
Plans Required ❑
! 7' ✓4441 �
Yes❑ Not Applic. ❑
Received ❑
VALUATION
9
SOURCE
OF
GAS
ELECTRIC
PUBLIC O
SEWAGE
Ownership
FEES COLLECTED
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 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-
Building
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
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buiping I IIN 180 DAYS
PERMIT NUMBER
6- �"
04-%- *1800
763.9'
08-11-83
6.479.
,Plan Check
SPA
Modular/
p,MFG.Home
Other (Specify) (U�
TOTAL
%J
$ �-
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
DATE ITEQ 'i f PERMIT 8. 0 or(;T L6(
a
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V
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