1983, 04-11 Permit: 83A-2837 FurnacePLAN NUMBER APPLIICATION /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.
1. E . I--DIO -S,3z'o
Fin. Basement
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I
I
OWNER
PHONE
PHONE
3.-3OVC;C
TYPE /N EW El ALT. El AD'N. El RPL. D MVE.No.
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
s (mss M 1 S'JL c'nl
�i�i �0 4.
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
1-`44"VC� IA -cc'
4.
or Variance
Qafo --I0S__?
Yes No[-]
I
I Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
C . IC_�)4< s EiT
V
cic::; ?te
I SOURCE
GAS
❑Yes El No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
UTILITIES
PRIVATE ❑
ADDRESS
ZIP
Main Floor
Upper Floors I
Garage/ Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE /N EW El ALT. El AD'N. El RPL. D MVE.No.
7. OF.// ElOTHER
WORK El BLD. ElPLMB. E! MECH. ❑ M. H. ❑ POOL
Certifi. of Exempt.
Required
Yes El No[-]
Number
or Variance
Received
Yes No[-]
DESCRIBE WORK,
8'
Shorelines/ Flood Hazard
Plans Required El
� �T
L ��l2r\1i�cE E macTv%� -
Yes Not Appl ic. ❑
Received ❑
VALUATION
9•
I SOURCE
GAS
ELECTRIC
WATER
0SEPCOwnershipOPIC
TIO
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ 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
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. SEER EVERIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT -- - DATE
Mech.
IAL APPROVALSI S
PRELIM. FINAL DATE
Env. Hea
Planning
Plans
Exam
IDE FOR NOTICE)
d'
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 $ )4" Oct
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEQJLI D 1 - PERMIT�Q. �' z * 14 0 0 ioiFAL