1983, 07-25 Permit: 83A-6191 Furnace PLAN NUMBER i APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ' ' -Ca 1 i
C., NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
r
STREET ADDRESS PARCEL NO.
ll-
LOT BLOC SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. 5fl 17-1.1 l ty4e;7 99.9 -PIO
MAILING ADDRESSZIT Actual Set Backs in Feet to:
A, C, /10 O 7a/4/ North I South [East `West
CO NTRAC� f / T^ LICENSEE EXPIRES PHONE�HSize of Parcel Zone Classification Residential❑
kflGE1i) s /`1/ 6 I /a 7-63 7 —D9 Commercial❑
4. ,.
ADDRESS- /� ZIP r' Type Const. Occupancy Sprinklered
&• 6i/s InFll/i/ L1�5F/� yw.�2 ❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area r=
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse - ii
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 ❑ OTHER
WORK ❑ BLD. ❑ PLMB7M.H. ElMECH. fl M.HPOOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBEWORKfit, c^/ Shorelines/Flood Hazard Plans Required❑
8. e4—e-c,/i G f��CNice- z. Uu cr -teak _ Yes El Not Applic.❑ Received El
VALUATION SOURCE GAS /ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF PRIVATE❑ SEWER PUBLIC CI SEPTIC O
UTILITIES X 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 REQ IRED INSPECTIONS Plumbing
SIGNATURE OF - APPLICATION ' `� Mecn. /'y. 07)OWNER OR AGENT i DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health ?,! /e
SEPA
Planning
Modular/
Fire �� MFG.Home ›
Prevent. o
a
Engineer Other(Specify) W
Utilities
TOTAL $ N. 6v
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
Building ' /7IN 075.-83 619, 1z * 14, 00_ I
-. 2
Tech. 5 DATE ISSUED PERMIT NO. TOTgL
A