1984, 03-22 Permit: 84A-2473 FurnacePLAN NUMBER
APPLICATION /PERMIT
PERMIT NUMBER
Fin. Basement
Unfin. Basement
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
�`�
6.
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
PARCEL NO.
No. Floors
1.
_ j/ -7 ;'. 5;
3
TYPE XNEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
LOT BLOCK SUBDIVISION
LEGAL DE CRIPTION:
2.
I I
7• OF ❑ OTHER
❑ BLD. ❑ PLMB. XMECH. ❑ M. H. ❑ POOL
3.
OWNER 4i /I,/--
PHONE PHONE
Number
MAILING ADDRESS
WORK
ZIP
ActualSet Backs in Feet to:
Yes El No❑
DESCRIBE WORKC
North South East West
Plans Required El8,
Received ❑
CONTRA CTOR
LICENSE EX IRESPHONE
.- lGc G
Size of Parcel
Zone Classification
Residential 1:1
1 Commercial ❑
4. ADDRESS r
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
SEWAGE
El
Ownership
FEES COLLECTED
9
OF
UTILITIES
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor ,area
I hereby certify that I have read and examined this application and have read the "NOTICE"
provisions included on
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
i
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE XNEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER
❑ BLD. ❑ PLMB. XMECH. ❑ M. H. ❑ POOL
Cevaii ofExempt.
Required
Yes El No❑
Number
WORK
or
Received
Yes El No❑
DESCRIBE WORKC
Shorelines/Flood Hazard
Plans Required El8,
Received ❑
.- lGc G
Yes Not Applic. ❑
VALUATION
SOURCE GAS
ELECTRIC
WATER
SEWAGE
El
Ownership
FEES COLLECTED
9
OF
UTILITIES
TPRIVATE
O
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
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF" APPLICATION
OWNER OR AGENTG __..._. DATE T ;,
Mecn•
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
>_
Fire
CL
C
Prevent.
6.3
Other (Specify)
LU
Engineer
.J
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Plans
Exam.
"
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
IN 180 DAYS
—
0 3— 2 2— 8 4 2 4 Z 3 z
* 2 0. 0 0 0 1 --
Tech.
A
i} J7
DATE ISSUED )" y RMIT NO.
TOTAL