1983, 11-16 Permit: 83B-1780 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUDDING CODES DEPARTMENT e3/3 /1R
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
MIII
JOB ADDRESS '
1. E. 11823 14th Ave. Veradale, WA. 99037 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
3 Dan Clark 928-9106
ADDRESS ZIP Actual Set Backs in Feet
N. 916 Ella Rd. Spokane, WA. 99206 North 'South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification
Custom Heating Co. 922-3315
4. *
ZIP Type Const. Occupancy Sprinklered x 0
S. 421 Dishman Mica Rd. 99206 Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
- ,
1
I 7.c:
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement r; y;
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE OD NEW ❑ ALT. 0 AD'N. ❑ RPL. El MVE.
7, OF ❑ OTHER
WORK
0 BLD. ❑ PLMB. g MECH. ❑ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) T
8. Install ductwork & Elec. furnace. I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9. Si ,127.0)JTILOITIES XXX Public 0 Private 0
/ Single $
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 Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority 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
DATE OF APPLICATION 1/ —
RI — -213'-213' SIGNATURE OF APPLICANT.���'`�,,� `�j/4` a:'"''f`*'" Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA ri
Planning c_)
Mobile Home "'
Fire Marshall J
ii
Co. Engineer Other (Specify)
Utilities 19.00
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
., ft4. rpt, , 't4 �
Building Technician PERMIT IS NONTRANSFERABLE 11 '1- 8 3 17'8. 0.5' * 1 9. 0 0,a R1 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL