1983, 07-22 Permit 83A-6842 FurnacePLAN NUMBER I APPLICATION/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
STREETADDRESS PARCEL NO.
n
2. LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
3. ,,.. -. R4AIk f-ICR[CF7-TN'
MAILING ADDRESS
CONTRACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
6. CHANGE OF USE FROM TO
PHONE '
ZIP I Actual Set Backe In
v9a/z
LICENSE EXPIRES PHONE
ZIP
PHONE
ZIP
TYPE 0 NEW O ALT. ❑ AWN. ® RPL. ❑ MVE.
% OF 0 OTHER
WORK O BLD. 71PLMB. }f MECH. ❑ M.H. ElPOOL
North
South Fast I West
Slat of Parcel
PRIVATE 0
Zone Classification
Residential
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
Commercial []
Type Oanat.
Occupancy
Sprinklered
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
Oyes ONo
❑Req'd.
New Cant. Valuation
Remodeled Valuation
Total Bldg. Fioor Area
Main Flow
Upper Floors
Garage/Storage
Greenhouse
Corer Deck
Uncv. Deck
Fin. Basement
Untin. Basement
No. Battle
No. Floors
No. Fin. Rooma
No. Dxellings
Certifl. of Exempt.
Planning
Required Yes[] No[]
Number
or Variance
Received Yes❑ No❑
DESCRIBEWORK lines/ Flood Har -rd Ran Required 1:1 Yes[] Not APPIIc.O Received 0
Shore
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 OF PUBLIC D SEPTIC ❑ FEES COLLECTED
Utilities
Plan PERMIT IS NONTRANSFERABLE
Exam PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /- IN 180 DAYS
Other (Specify)
TOTAL $ /LL
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
— (.1j,
04* ;a *1600
*16.006
A *0.00 0
684.1 ;F
07-22-83
2 6479.
DATE45SUE� — 8 3 PERMIA9. 2 * 16. 0 D PO1`AL
UTILITIES
PRIVATE 0
SEWER 0
Public 0 Private 0
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-
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 REOUIRED INSPECTIONS
Plumbing
SIGNATUREDF APPLICATION
% - l"
OWNER OR AGENT -= DATE -j
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Utilities
Plan PERMIT IS NONTRANSFERABLE
Exam PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /- IN 180 DAYS
Other (Specify)
TOTAL $ /LL
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
— (.1j,
04* ;a *1600
*16.006
A *0.00 0
684.1 ;F
07-22-83
2 6479.
DATE45SUE� — 8 3 PERMIA9. 2 * 16. 0 D PO1`AL