1983, 09-29 Permit: 83A-9690 Furnace PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY elAN '670
C--- NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
ST ETADD ESS 676- t'PARCzEL NO.
1. a /a, q A a / 7
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWN PHONE PHONE
3.
t,44111Z-ZR-Esj 1 ZIP Actual Set Backs in Feet to:
ld z-t— /o 9 . / /7 North 'South East I West
CONTRACTOR LICENSE EXPIRES PHONE it975
Size of Parcel Zone Classification RRemmential O
4. ,.....770e,‘"
;7 'LflZC�G" /ie.
.r / ,f 4/ 5-3 "
t=2_,5 a ZIP Type Const. Occupancy Sprinklered
5a 5/ *-‘,,;,1/ a--- ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 'i (_ .
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
s. .
TYPE ❑ NEW 0 ALT. ❑ A N. 0 RPL. El MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
'. oF WORK C] BLD. LI PLMB. y`",/MECH. ❑ M.H. ❑ POOL OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No El
8.e��SCRI E K Shorelines/Flood Hazard Plans Required❑
id f Oro g 1(,4/ .a-a.„ -� -�°L", Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGA ELECTRIC WATPUBLIC❑ SEPTIC SEWAGE Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ SEWER❑ 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 REQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION G� 1 !j
OWNER OR AGENT )fZ�me- — ' DATE / J r�3 Mech. v"
SPECIAL APPRO1Ef'ALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE_ / /�� ',�/J//J Plan Check
Env.Health ' F` d
SEPA
Planning
Modular/
Fire MFG.Home a
Prevent. �l j 'r R f /1 . o
Engineer Other(Specify) CO 0 ITV v
W
J_
Utilities '
LL
69
TOTAL $
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 . 9 Q G st 1 6, 0 a i.
Building j• IN 180 DAYS U 9 -29 — '6
Tech. I DATE ISSUED PERMIT NO. TOTAL