1983, 10-25 Permit: 83B-829 FurnaceAPPLICATION/PERMIT
PLAN NUMBERSPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
A NORTH 811 JEFFERSON /SPOKANE, WASHIt'GTON 99260 / (509) 45667
LOT BL CK
2.
OWNER
3.
MAILING AfDDRESS
4' ADDRESS
5. ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HAHU I v IVItAr"- "
PARCEL NO.
.� `��n� LEGAL DESCRIPTION:
01
-9
LICENSE ES PHONE
ZIP
PHONE
ZIP
_Cc, 1Zj
Actual Set Backs in Feet to: West
South East
North Zone Classification Residential ❑
Size of Parcel Commercial ❑
Occupancy Sprinklered
❑Req'd.
No
Type Const. ❑Yes
Total Bldg. Floor Area
New Const. Valuation Remodeled Valuation
Main Floor Upper Floors
Garage/Storage Greenhouse
Cover Deck Uncv. Deck
Fin. Basement Unfin. Basen
PRELIM. FINAL DATE
Env. Heal
Planning
Prevent.
Engineer
Utilities
EP A_
PERMIT IS NONTRANSFERABLE
Plans PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Exam. IN 180 DAYS
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
VAL
THIS BECOMES A PERHEN MACHINEIM TT
DATEISS'UED? — J
IN TH
PERMIT NO: 2.9 z * 19-11 0 _j
TONo.
CHANGE OF USE FROM No. Floors
No. Baths
No. Fin. Roo ms Dwellings
6
� ❑ RPL. 7 MVE.
TYPE l� NEW ❑ALT. ❑ ASD.' N. El OTHER Certifi: of Exempt. Required
Received
Yes[] NOD Number
Yes❑ No❑
7.
OF ❑ PLMB. �'MECH. ❑ M.H. ❑ POOL or Variance
❑ BLD.
Shorelines/Flood Hazard
Plans Required C'
L,
WORK
Yes❑ Not Applin ❑
Received
DESCRIBE WORK
1 7
FEES COLLECTED
8.
- EL CTR ATER SEWAGE Ownership
5 RCE GAS P BLIC ❑ SEPTIC r_1 public ❑Private ❑
SEWER ❑
9,
VALUATION OF PRIVATE ❑
UTILITIES rovisions included on
have read the "NOTICE" P
I hereby certify that I have read and examined this application and
to be true and correct. All provisions of laws and ordinances governing this type o
a
Building
reverse side, and know the same permit steuct otnpoe the performance
specified herein or not. The granting of
with whether sp law regulating co
Plumbing �—
work will be complied
thority to violate or cancel the provisions of any other state or local
REQUIRED INSPECTIONS
of construction. SEE REVERSE SI FOR
APPLICATION / v _Z _ �3
Mach.
DATE
SIGNATURE OF
OWNER OR AGENTPlan
__ _...... cocr lAl CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Check
PRELIM. FINAL DATE
Env. Heal
Planning
Prevent.
Engineer
Utilities
EP A_
PERMIT IS NONTRANSFERABLE
Plans PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Exam. IN 180 DAYS
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
VAL
THIS BECOMES A PERHEN MACHINEIM TT
DATEISS'UED? — J
IN TH
PERMIT NO: 2.9 z * 19-11 0 _j