1984, 02-21 Permit: 84A-1408 FurnacePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACIES - PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT BLOCK suBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3 MAILING ADDRESS ZIP Actual Set Backs in Feet to:
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
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 $ #JO - t' ,
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PE M^IT NUMB R
tt —
04* *20.00
*2000
A *0,00`3
14072
02-21-84
2 6479.
PERMIT�
DATE�S6UE� 1 tj ` lJ9. S z * Z U. CFTAL
CL
O
t_3
W
J
U_
North South East
I West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential El
Commercial ❑
4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
. l
C'l 2
❑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
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE �r'VEW El ALT. El AD'N. 11 RPL. ❑ MVE.
7. OF ❑ OTHER
❑ BLD. ❑ PLMB.XMECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes L) No❑
Number
WORK
or Variance
Received
Yes❑ No❑
DESCRIBE WORK/(.j�}
�v1
ShoreFlood Hazard
Plans Required ❑
8• LV- ( V C1.LGr�i1fC. -
Yes L]Not Applic. ❑
Received ❑
VALUATION
I SOURCE
GAS
ELECTRIC
I WATER
PUBLIC ❑
SEWAGE
SEPTIC L19•
Ownership
FEES COLLECTED
UTILOITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
1 hereby certify that 1 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
9
SIGNATURE OF y,., � .-; ' .�/� APPLICATION
�,� '
OWNER OR AGENT 1h�= r't DATE ___.__
Mech.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
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 $ #JO - t' ,
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PE M^IT NUMB R
tt —
04* *20.00
*2000
A *0,00`3
14072
02-21-84
2 6479.
PERMIT�
DATE�S6UE� 1 tj ` lJ9. S z * Z U. CFTAL
CL
O
t_3
W
J
U_