HomeMy WebLinkAbout1984, 03-12 Permit: 84A-2081 FurnacePLAN NUMBER APPLICATION/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.
LOT BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2.
OWN R �`�/� PHONE PHONE
3. r
MAILING DRESS ZIP Actual Set Backs in Feet to:
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ a
PERMIT NUMB��E,R��pp��
Ga
0
0
04* *20.00
*200064
A *0.00 00
208,8
03-12-84
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATi its lmp 2 8 A. PERMIZ 1P9 1 z
* 2 0.O O aTOTAL
d
O
C:1
W
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"7--C
North South East
I West
CONTRACTOR_ _
LICENSE EXPIRES
N n
Size of Parcel
Zone Classification
Residential E]
Commercial ❑
4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
�l `t
5P
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
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7•
OF El OTHER
❑BLD. ❑ PLMB. 1-1 MECH. ❑ M.H. E3 POOL
Exempt.
Required
Yes❑ No❑
Number
WORK
or Variance
Received
Yes❑ Nol
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.
— l , o �? �c. / <y?
Yes El Not Applic. El
Received ❑
VALUATION
SOOUFCE
GAS
E�,ECT�tIC
WATER
SEWAGE
Ownership
FEES COLLECTED
9.
UTILITIES
//
PRIVATE O
SEWER O
Public El Private ❑
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
Plumbing
SIGNATURE OF�� %/ _ APPLICATION
3 ` 1?`' I
OWNER OR AGENT ✓ i ISCJ 0i' DATE
Mech.
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ a
PERMIT NUMB��E,R��pp��
Ga
0
0
04* *20.00
*200064
A *0.00 00
208,8
03-12-84
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATi its lmp 2 8 A. PERMIZ 1P9 1 z
* 2 0.O O aTOTAL
d
O
C:1
W
J_
U_