1982, 12-10 Permit: 82B-1848 Furnace PLAN NUMBER APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY L - ~ ) eFef
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
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APPLICANT:'COMPLETE NUMBERED SPACES -_PRESS HARD TO MAKE 3 COPIES
1
STREET ADDRESS ..--••• 4:6„,..6172t"o M PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
3. OWNE 4///I 1-4 PHONE PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
North 'South East `West v (i " * i ,
CONTRACTORResidential❑
° /1 LICENSE EXPIRES PHONE Size of Parcel Zone Classification 1 U 0
4. ��.1 'r ,(�/mss _ Commercial❑ _
ADDRESS ZIP
C1' ZIP Type Const. Occupancy Sprinklered
�C 1 ••.23 ill=L�s ❑Yes 0 N ❑Req'd. 1 s.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
1 eL- 1 u — s2_
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse _ 6 (1 7 0
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 VIEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 WORK '.BLD. ❑ PLMB. fsMECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes El No Number
!!! II or Variance Received Yes NoD
DESCRIBE WOR . . / Shorelines/Flood Hazard Plans Required❑
8• �,�` / dier4
/ Yes❑ NotApplic.❑ Received ❑
VALUATION /// SOURCE GAS ELECTRICWATER SEWAGE OwnershipOF UBLIC❑ SEPTIC❑ FEES COLLECTED
9 UTILITIES IVATE❑ SEWER❑ 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 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 , state or local law regulating construction or the performance
of construction.SEE REVERS - - OR REQ D INSPECTIONS Plumbing
SIGNATURE OF , r> APPLICATION
OWNER OR AGEN������ / _ ; - DATE _.....i —42_2- --.3.__—,g Mech. 4 ,
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVER E SIDE FOR NOTICE)
PRELIM. FINAL DATE rd pJ. t,A 3. -J - 0 0 Plan Check
Env.Health h _'
. Fir( if' ) 2 f C)L7 SEPA
Planning _
Modular/
Fire F5?-.111 10- C)42 MFG.Home ),
Prevent. ii 0
Engineer 1 . ov Other(Specify) C)
W
IL
Utilities IS,
TOTAL $
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
Tech ing Xct ) 2
DATEE IN 180 DAYS —� PERMIT 0 —8 2 ]��S4.8 * 1 8, a�oolrAL
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