1983, 10-03 Permit: 83A-9829 FurnacePLAN NUMBER APPL ICAT ION /PERMIT P EMITUMB
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ��
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS 4 PARCEL NO.
2. LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
WORK ❑ BLD. ❑ PLMB.)<MECH. ❑ M.H. ❑ POOL
O
s C
PHONE/
PHONE
Number
or Variance
3.Jf1G
Yes E] No El
DESCRI E WORK _ n [
8. 2 3 l% 7 �/�'d A� A- ✓�4;!
Shorelines/ Flood Hazard
Plans Required ❑
/s , �L _�4 ��
Yes El Not Applic. ❑
MAILING ADDRESS
VALUATION
ZI�j� f
�c
Actual Set Backs
in Feet to:
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
J
North
South
East West
CONTRACTOR
LICENSE EXP RES
PI?NS
�3 1711
Size of Parcel
I hereby certify that I have read and examined this application and have read the "NOTICE"
Zone Classification
Residential ❑
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
BANNER FURNACE & FUEL, INC.
— /—
Building
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
Commercial ❑
4.
f!
OWNER OR AGENT DATE
Mech.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
P. 0. Box 4346
99202
1
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
�J.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
//
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE13 NEW El ALT. El AD' N.
'RPL. El MVE.
7
❑ OTHER
WORK ❑ BLD. ❑ PLMB.)<MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes 13 Noo
Number
or Variance
Received
Yes E] No El
DESCRI E WORK _ n [
8. 2 3 l% 7 �/�'d A� A- ✓�4;!
Shorelines/ Flood Hazard
Plans Required ❑
/s , �L _�4 ��
Yes El Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9
PRIVATE 11SEWER
❑
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
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
APPLICATION
�
SIGNATURE OF , ��2y21�
f!
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS SPECIAL CONDI ONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
PRELIM. FINAL DATE
Planning,51111�� 7C�/'�f%j°/C G � ,�✓
Fire (/�i0 Alv
Prevent. \ ✓� E) >
Engineer
Utilities
SEPA
plansPERMIT IS NONTRANSFERABLE
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building10A IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
2 -2 25e -
TO. AL
5TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�02.9z
p=03-83
DATE IS UED PERMIT NO.
*22,00°I-
TOTAL
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