1983, 12-13 Permit: 83B-2479 FurnacePLAN NUMBER APPL ICAT ION /PERMIT
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 PARCEL NO.
Floors I No. Fin. Rooms I No.
TYPE ❑ NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE.
/
41
7. OF ❑ OTHER
❑ BLD. ❑ PLMB.&MECH. ❑ M.H. ❑ POOL
LOT
BLOCK
SUBDIVISION
C Exempt.
LEGAL DESCRIPTION:
Yes❑ No❑
2.
WORK
ai.
or
Received
yes No
DESCRIBE WORK
���
Shorelines/ Flood Hazard
OWNER
8.f L y�
Yes El NotApplic. ElReceived
PHONE
PHONE
FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER El Public El Private ❑
3.
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
,cef
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
MAILING ADDRE2S
Plumbing
SIGNATURE OF APPLICATION
�
ZIP
Actual Set Backs in Feet to:
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
�,e
Plan Check
PRELIM. FINAL DATE
North South
East West
CONTRACTQ9
SEPA
Planning
LICENSE EXPIRES
PHONE
Size of Parcel
Fire
Zone Classification
Residential
�� ;�M•
Other (Specify)
S
Commercial ❑
4
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
,5�; zei /
❑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
Uncv. Deck
Fin. Basement
Unf in. Basement
6.
Floors I No. Fin. Rooms I No.
TYPE ❑ NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
❑ BLD. ❑ PLMB.&MECH. ❑ M.H. ❑ POOL
C Exempt.
Required
Yes❑ No❑
Number
WORK
ai.
or
Received
yes No
DESCRIBE WORK
���
Shorelines/ Flood Hazard
Plans Required ❑
8.f L y�
Yes El NotApplic. ElReceived
El
VALUATION SOURCE GAS ELECTRIC I WATER SEWAGE I Ownership
OF PUBLIC ❑ SEPTIC El
FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER El Public El Private ❑
1 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 REVERS IDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
�
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
`
MFG. Home
Fire
Prevent.
�� ;�M•
Other (Specify)
Utilities 11 O
TOTAL $
SEPA
t
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATE
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS_ '3
Tech. YI7�1/I i /'moi DATES E ^
PERMIT NUMBER
63f� — 2-1 79
EYED
PERMIT`N4 9z * 1 a 0 0 10�11AL