1983, 09-23 Permit: 83A-9437 Furnace, Piping PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY U - 74-37
C- NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. . /.Y 3n V /1/3..fAV I
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. �1L GJld✓ou /,24.-;)733
MAILING . DRESS/ ZIP Actual Set Backs in Feet to:
/l: -,L.
9..;z' 6 North South East I West
CONTRACTOR- / --, LICENSE EXPIRES PHONESize of Parcel Zone Classification Residential❑
4. /Z C,.1("4,14�(' X07- a../-/Y _ 9.76—/S&'._� Commercial❑
ADDRESS 'i 6 tom, �� � Pa9 "� Type Const. Occupancy ❑Yes Sprinklered❑No ❑R d.
DESIGNER ; PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. _ _ L L * w1 CO
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
* 1 0 0 Y
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement i,
6. t;
TYPE 0 NEW ❑ ALT. 0 AD'N. 0 RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings 4 E
7. OF ❑ OTHER z
WORK ❑ BLD. ❑ PLMB. C*MECH. ❑ M.H. El POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No E.7 -
6 4 7 y. '.
DESCRIBE WORK� Shorelines/Flood Hazard Plans Required❑
1��
8• /� ,�z;le, "d re reitl vyz,,`._, i /"`gAiC Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEDGAS ELE//CC//TRIC PUBLIC O SEWAGE
Ownership FEES COLLECTED
9 UTILITIES 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 OFAPPLICATION
OWNER OR AGENT '!—[-c DATE / / —13 Mech. /)7'O
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. d
O
Engineer
Other(Specify) v
W i
J_
Utilities LL
TOTAL $ l�06
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED _ o O
Building IN 180 DAYS 9 3 4 3. z * 18.
Tech. /��
( DATE ISSUED PERMIT NO. 1 TOTAL