1983, 05-10 Permit: 83A-3862 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY v1-7/k - 12 66 Z-
y NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS •
PARCEL NO.
? 1' E. I o 4-0,Ap11 e- (7.14 ems` Gast of/96404.s SPO/L12)
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2. .1/I yy�
OWNER Suri #0/1101a'_S PHONE PHONE
3.
fA.)P... C.aNsi-Retc%IOiv iRV-bGr0
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
Pro , 'BOA pio4141 717215, North [South [East I West
CONTRACTOR / i LICEN•E EXPIRES PHONE Size of Parcel Zone Classification Residential❑ _
76 it C • 9• ..22.-o .6o Commercial❑
ADDRESS ZIP p / Type Const. Occupancy Sprinklered
E. %1 is- M lousf/�'[.t) 99�f 06 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area i
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck - Uncv.Deck Fin.Basement Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms —No.Dwellings
TYPE RA NEW El ALT. El AD'N. El RPL. El MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. N MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ .Number
or Variance Received Yes❑ No❑
DESCRIBE''p � WORK a (� Shorelines/Flood Hazard Plans Required❑
8' Nef� ,FLEcTP./c FUg�ry slcc Duca — 400/2/ Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELS TRIC WATER SEWAGE Ownership FEES COLLECTED
9. OF
UTILITIES PUBLIC❑ SEPTIC❑
PRIVATE D 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 other state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
OWNER ORAPPLIGENTSIGNATURE OF /l/ DATECATION Mech. 61 CD
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
P.P/Li/+.,,u.' ,/ /0. Oa SEPA
Planning
Modular/
7S4 MFG.Home
Fire d
Prevent. Y.5't> v
Engineer b L�rW . Other(Specify)
W
LY /9, :6-0J_
Utilities �i � �
TOTAL $ /51' O'a
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BTuilding �� IN 180 DAYS 0 0 _8
/1DATE ISSUED PERMITS.6, 21 *1 4 0 0AL