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1983, 10-05 Permit 83A-9968 FurnacePLAN NUMBER APPLICATION/PERMIT "l 1 SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY a/DOJ i. NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 PERMIT NUMBER g A- 2x,0 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1. 2. STREET ADDRESS LOT /BLOCK OWNER IUBDIVISION " e"Li`if--)/ 3,4 / . c(', /F'ci vv MAILING ADDRESS CONTRACTOR �— / 4. P� /o�Qd �zr Deaf ADDRESS PHONE 7* ' LICENSE EXPIRES PHONE ZIP PHONE 3a6zf5'c' ZIP PARCEL NO. LEGAL DESCRIPTION: Actual Set Backs In Feet to: North I South Size of Parcel Type Const. Occupancy [East West Zone Classification Residential 0 Commerclal 0 Sprinklered ❑Yes ❑No ❑Req'd. DESIGNER 5. ADDRESS PHONE New Const. Valuation Remode ed Valuation Total Bldg. Floor Area ZIP Main Floor Upper Floors Garage/Storage Greenhouse 6. CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unlin. Basement TYPE 0 NEW gi-ALT. 0 AD'N. 0 RPL. ❑ MVE. 7. OF 0 BLD. 0 PLMB. 0 MECH. 0 M.H. WORK ❑ POOL ❑ OTHER No. Baths No. Floors No. Fln. Rooms No. Dwellings Certif I. of Exempt. or Variance Required Yes❑ No❑ Received Yes No❑ Number DESCRIBE WORK VALUATION 9. U lcid 07 en, Shorelines/Flood Hazard Yes❑ Not Appllo. ❑ Plans Required 0 Received 0 SOURC OF UTILITIES GAS ELECTRIC WATER PUBLIC 0 PRIVATE ❑ SEWAGE SEPTIC ❑ SEWER ❑ Ownership Public 0 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 work will he 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 SIGNATURE OF /f OWNER OR AGEN `g APPLICATION DATE SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Env. Health Planning Fire Prevent. • Engineer Utilities SEPA Plans Exam. Building Tech. 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 $ /6 �� 04* *16,00 * 1 6006 A *0,00 9967- 10-05-83 ." 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. o win 5 8 ' DATE�SSUEl7 - PERMIT9N01 8 Z * 16, 0 0 AL A N