1983, 05-04 Permit: 83A-3627 FurnacePLAN NUMBER APPLICATION /PERMIT FPSffffIT NUMBER
on I SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY �r _
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
s.
APPLICANT: COMPLETE NUMBERED SPACES -
PRESS HARD TO MAKE 3 COPIES
No. Floors
STREET ADDRESS
No. Fin. Rooms
No. Dwellings
PARCEL NO.
L1RPL. ❑ MVE.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
Certif i. of Exempt.
Required
Yes❑ No❑
Number
OWNER
PHONE
PHONE
//
DESCRIBE WORK
3
cGGa
Plans Required ❑
8• /�'f; - % :
.. 41
Yes El Not Applic. ❑
MAILIN'ADDRESS
Received ❑
ZIP
Actual Set Backs in Feet to:
GASELECTRI"C
I WATER
PUBLIC ❑
North South East West
Ownership
1
CONTRA TOR
LICEN E XPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
>
>
�1� �///3/
Commercial ❑
4.
L
/
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑Req'd.
DESIGNER
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation TTotal
Bldg. Floor Area
5.
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement
s.
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
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
SIGNATURE OF _ APPLICATION
OWNER OR AGENT 'Y7 DATE
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
Plans
Exam.
M1
TIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ '
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
05 -0 4 -8 3
DATE ISSUED
04* * 1 4.00
* 1 4,006'
A *0.00
36262
05-04-83
;9 6479.
362,72 *140�
PERMIT NO. O0 -L
CL
O
C3
W
J
LL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE p NEW ElALT. ElAD' N.
L1RPL. ❑ MVE.
7 OF
❑ BLD. ❑ PLMB. I(MECH.
❑ OTHER
❑ M.H. ❑ POOL
Certif i. of Exempt.
Required
Yes❑ No❑
Number
WORK
or Variance
1
Received Yes No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8• /�'f; - % :
.. 41
Yes El Not Applic. ❑
Received ❑
VALUATION
I SOURC
OF
GASELECTRI"C
I WATER
PUBLIC ❑
I SEWAGE
SEPTIC ❑
Ownership
1
1
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
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
SIGNATURE OF _ APPLICATION
OWNER OR AGENT 'Y7 DATE
PRELIM. FINAL DATE
Env. Health
Planning
Utilities
Plans
Exam.
M1
TIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ '
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
05 -0 4 -8 3
DATE ISSUED
04* * 1 4.00
* 1 4,006'
A *0.00
36262
05-04-83
;9 6479.
362,72 *140�
PERMIT NO. O0 -L
CL
O
C3
W
J
LL