1983, 04-11 Permit: 83A-2835 Furnace, PipingPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASIi1NGTON 99260 / (509) 456-3675
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑RPL. ❑ MVE.
!•
APPLICANT: COMPLETE NUMBERED SPACES
- PRESS HARD TO MAKE 3 COPIES
No. Fin. Rooms
STREET ADDRESS
OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. IV/MECH. ❑ M.H. ❑ POOL
�.
rz_ wito -B--5 O
PARCEL NO.
2.
LOT
I BLOCK
I SUBDIVISION
Received Yes El No❑
LEGAL DESCRIPTION:
DESCRIBE WORK
8• hh
C'tt4S �tl�aV Clpl�
OWNER
PHONE
PHONE
Yes Not Applic. ❑
Received ❑
VALUATION
9
SOURCE
OF
GAS
ELECTRIC WATER
PUBLIC ❑
SEWAGE
SEPTIC ElFEES
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
UTILITIES
E -Z6ZS 55 H
Q Gf ;;ws
North South East West
Public ❑ Private 07
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
4.
tv ,'„k—C(;,
C0!v - 706i
Plumbing
SIGNATURE OF�y��' -- APPLICATION
Residential El
Commercial ❑
OWNER OR AGENT DATE
ADDRESS
ko'*Os BTt�
ZIP
Type Const.
Occupancy
Sprinklered
Plan Check
Lig
:LC7G
❑Yes ❑No El Req Id.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑RPL. ❑ MVE.
!•
Baths
No. Floors
No. Fin. Rooms
No. Dwellings
OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. IV/MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required Yes El No❑
Number
or Variance
Received Yes El No❑
DESCRIBE WORK
8• hh
C'tt4S �tl�aV Clpl�
Shorelines/ Flood Hazard
Plans Required ❑
c3i n �(�Ifv
Yes Not Applic. ❑
Received ❑
VALUATION
9
SOURCE
OF
GAS
ELECTRIC WATER
PUBLIC ❑
SEWAGE
SEPTIC ElFEES
Ownership
COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private 07
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 REVS SE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF�y��' -- APPLICATION
OWNER OR AGENT DATE
Mech. ( 6.00
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Hea
Planning
01
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam.
Buiding PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech.lfr IN 180 DAYS
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ ('g '00
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
Q>3R- z j' r
PACE,
DATEYSSUEDL I— d 3 PERIVIA . 3. 5 z * 1 8. 0 J -' --j L
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