1983, 11-16 Permit 83B-1747 FurnaceNrrLIVA 1 RAW r tiivi1 I
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
ae i7'/i
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
STREET ADDRESS
1.
LOT
2.
BLOCK
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
/C5 / E
SUBDIVISION
3.
4.
5.
6.
OWNER
MAILING ADDRESS
CONTRA V' [S 71C14zFJ )Lh L =,;
ADDRESS 6_• h/) 30 /L1' SS / ��-
DESIGNER
ADDRESS
CHANGE OF USE FROM TO
)/262 e ' 1 Nt✓
LICENSE EX8PIR S
tl -Lf
PHONE
ZIP
7
PHONE
ZIP
PHONE
ZIP
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South East ( West
Size of Parcel 4I Zone Classification
Type Const.
Occupancy
New Const. Valuation
Residential ❑
Commercial 0
Sprinklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Main Floor
Upper Floors
Garage/Storage
Cover Deck
Uncv. Deck
Fin. Basement
Total Bldg. Floor Area
Greenhouse
Unfin. Basement
TYPE ? NEW
7. OF
WORK D BLD.
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes
No ❑
Number
DESCRIBE WORK
8. /.S-s t.' F uevhiC t� cL c. t` sq /7ry7
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE
9 OF PUBLIC ❑ SEPTIC ❑
UTILITIES PRIVATE 0 SEWER ❑
Shorelines/Flood Hazard Plants Required 0
Yes ❑ Not Apollo. ❑ Received ❑
Ownership
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 REVERS SIDE FOR REQUIRED INSPECTIONS
2'q(G/ s
APPLICATION //—/S_ 33
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
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
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular!
MFG. Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE itsieD 1 U — 8 3
PERMIT 14d.' 7 z
*1400,.i7;,L