1984, 03-12 Permit: 84A-2084 Furnace Ammiaisic
PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY e4A - Mel
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS I PARCEL NO.
1. 4/ ':`,?s ,. .,2
LOT BLOCK SUBDIVISION ' LEGAL DESCRIPTION:
2.
OWNER _ PHONE PHONE
3. /% J 1:Ez-I/v.pc ,,-,,44-7/4,w
MAILING ADDRESS✓ / _ ZI t� �y f Actual Set Backs in Feet to:
<4 k.22/,/C% 1/ //� z / North 'South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
Commercial❑ CI *
ADDRESS: ZIP Type Const. Occupancy Sprinklered Y
f �; . 3C/ /7/;";)4/- ❑
❑Yes No ❑Req'd. * 2 0.0 0 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area A * C.0 0 8
5. 208.32
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement 0 3- 1 2-B
6. 2 6.479.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. RPL. ❑ MVE.
7. OF / ❑ OTHER
WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes 17 Non Number
or Variance Received Yes 17 No E]
,DTSCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8.X t;`<-/"J e `I f/.,/X,e4 ,1 =f!„� Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9UTILITIESPUBLIC CI SEPTIC CI
LI
_ PRIVATE DISEWER❑ Public CIPrivate El
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 OF —41 APPLICATION
OWNER OR AGEN t .��'r-i "�Z DATE d b.. Mech. /7--Ze:')
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE / /5.7-4-
/ Plan Check
Env.Health /k4/4 �`/ qf. //1/�y 2 "/��j eee, 7-f
SEPA
Planning Modular/
Fire MFG.Home d
Prevent.
O
Other(Specify) V
Engineer Lid
J_
Utilities
TOTAL $ ,77-‘ 7!
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buildingrril -.
Tech. 4 5/2 I N 180 DAYS DATE`1SSUED� 2 -8 4 PERMIT .8.4 z * 2 O. O 0 a C AL