1983, 07-22 Permit: 83A-6831 Heater, PipingPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
CHANGE OF USE FROM
TO
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
I Uncv. Deck
STREET ADDRESS
s.
PARCEL NO,
No. Baths
No. Floors
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
], OF ❑ OTHER
❑BLD. ❑ PLMB. ❑ MECH. ❑ M.H. r�OOL
I
Required
YesNo❑
p{�q
Pj O� /
(7!
3
Yes❑ No❑
PJ2_6PHONE
DESCRIBE7�^0RK / (�
8. .S7 4I/ 175i-" (/ (Q 9L
lG
Plans Required ❑
Received ❑
VALUATION SOOURCE GAS ELECTRIC I WATER I I SEWAGE Ownership
PUBLIC ❑ SEPTIC ❑
FEES COLLECTED
MAILING ADDRESS
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
ZIP
Actual Set Backs in Feet to:
Building
1 ' E ��
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
North South East West
of construction. SEER EV"EIDE FOR REQUIRED INSPECWOJ#S
CT�QQ�TOR�
%f�
Mach. j�•�
LICENSE EXPIRES
PJ Ip
1�
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
Plan Check
��
SEPA
Planning
Modular/
MFG. Home
4
DRESS
X j j )
�t (D
Z P
Type Const.
Occupancy
Sprinklered
[]Yes❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
I Uncv. Deck
Fin. Basement Unfin. Basement
s.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW 1:1ALT. ElAD'N. ❑ RPL. F-1 MVE.
], OF ❑ OTHER
❑BLD. ❑ PLMB. ❑ MECH. ❑ M.H. r�OOL
« (iiafE empt.
Required
YesNo❑
Number
WORK
Received
Yes❑ No❑
DESCRIBE7�^0RK / (�
8. .S7 4I/ 175i-" (/ (Q 9L
Shorelines/ Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION SOOURCE GAS ELECTRIC I WATER I I SEWAGE Ownership
PUBLIC ❑ SEPTIC ❑
FEES COLLECTED
public El Private 119• UTILITIES PRIVATE El SEWER El
I
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. SEER EV"EIDE FOR REQUIRED INSPECWOJ#S
Plumbing
—
SIGNATURE OF /J APPLICATI10 7-2- Z
�'�
Mach. j�•�
OWNER OR AGENT ' �" DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE � / �'7 j 5 ,� � O �
Env. Health ^f / r�V
Plan Check
SEPA
Planning
Modular/
MFG. Home
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building — •7/ il IN 180 DAYS
Other (Specify)
PERMIT NUMBER
3P�' •3(
TOTAL $ tG- o� I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. Q 1
DATEQs$UE� -8 5 PERMIAS. A 1 z
* 19.0 O *o'rAL