1983, 08-24 Permit: 83A-8167 Furnace, Heat PumpPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
% NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESIGNER
PHONE
APPLICANT: COMPLETE NUMBERED SPACES —PRESS
HARD TO MAKE 3 COPIES
Total Bldg. Floor Area
STREETADDRESS
PARCEL NO.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
LOT
BLOCK
TO
SUBDIVISION
Uncv. Deck
LEGAL DESCRIPTION:
2.
I
I
No. Baths No.
OWNER
PHONE
PHONE
3.
Lz
t4ZO
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
Number
❑ BLD. ❑ PLMB. P MECH. ❑ M.H. El POOL
WORK
oCar'iance
Received Yes 11 No❑
North South East West
DESCRIBEWORK i
CONTRACTOR
Plans Required ❑
8' 1Al `i E�-Ez—TP. �L Fuczuvw1�lr_
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential El
4.
�E
} �TCa e
Ownership
Q 7
9•
I UTILITIES
Commercial ❑
ADDRESS
SEWER ❑
Public ❑ Private ❑
ZIP
Type Const.
Occupancy
Sprinklered
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 REVEME SIDE FOR REOUIRED 0PECTIONS
Plumbing
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuatiori7
Total Bldg. Floor Area
�J.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basemi
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW 1:1 ALT. El AD' N. El RPL. ❑ MVE.
%. / ❑OTHER
empt.
Required Yes❑ No❑
Number
❑ BLD. ❑ PLMB. P MECH. ❑ M.H. El POOL
WORK
oCar'iance
Received Yes 11 No❑
DESCRIBEWORK i
Shorelines/ Flood Hazard
Plans Required ❑
8' 1Al `i E�-Ez—TP. �L Fuczuvw1�lr_
Yes❑ NotAPPlic. ElReceived
❑
VALUATION
SOOURCE
GAS
ELECTRIC
PUBLIC ❑
SEWATER PTIC ❑
Ownership
FEES COLLECTED
9•
I UTILITIES
PRIVATE ❑
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 REVEME SIDE FOR REOUIRED 0PECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mech•1a.Ori
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Modular/
Planning
MFG.Home
0
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Other (Specify)
PERMIT NUMBER
TOTAL $ al C
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 4ED2 4 — 8 PERMIT 6 7 z * 19. 0 0 -&+AL
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