1983, 09-16 Permit: 83A-9124 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY " a14-'
C___ NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
,�y� ,1 PHONE, PHONE
3. OWN / /V L �'?` // ,v s k l `/,"�^ Y`,/ Actual Set Backs in Feet to:
MAILING ADDRESS , ` 41 n 4,1 ZIP_? e
�( , Y� ,+� ��// ,C�f• � [I North South East West
l " r •' Size of Parcel Zone Classification Residential❑
CONT��+`CTO�,�/ � ` Ejle-5
XPIRES P NE Commercial❑
4. 1`'--`t- ni u .- Ill '-`;I04),
• ZI Type Const. Occupancy Sprinklered U ci * * 1 7. u 0
ADDR t' ❑Yes ❑No ❑Raga.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. -
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse ., r_ c_,
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement U .-— j z - 3
6. 'No.Baths No.Floors No.Fin.Rooms No.Dwellings __ f, 4 7 9
TYPE 1K NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER
7' OF ❑ BLD. ❑ PLMB. .MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number
WORK or Variance Received Yes❑ No❑
A Shorelines/Flood Hazard Plans Required ID$. CRIB_WOR1CK ��13 � la4124.-Lf1.ti k,aLt•l , , Vest: Not Applic.ElReceived ❑
VA ATION SOU CE GASiE CTRIC WATER SE IAGE Ownership FEES COLLECTED
9. UTILLIITIESPUBLIC❑ SEPTIC CIPRIVATE 0 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 Plumbing
of construction.SEE REVERSE SIDE FFO_R_REOUIR�• INSPECTIONS
SIGNATURE OF ' t r DATE
CATION 9"_a F-3 Mach / 7
OWNER OR AGENT
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERS �SIID�i�EFOR DTIC Plan Check
PRELIM. FINAL DATE (Q �!41 ( O L- /A !/
Env.Health 1`xL✓� C.- 1.41 0'^ SEPA
C--ekt
Planning
Modular/
MFG.Home �
p
PrePrevent. V
�, - Other(Specify) W
/r ' J
Engineer f r-
Utilities / 0-1)6
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PERMIT IS NONTRANSFERABLE
Plans THIS BECOMES A PERMIT.
ten' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 4
Building 'A I 0 DAT UE IN 180 DAYS
Tech. +/ S —d 6 —8 3' PERMII9N1.�a z * 1 ?, 0 0 ¢04AL