1983, 09-20 Permit: 83A-9260 Oil furnace To GasPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
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SUBDIVISION
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ADDRESS A •
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5.
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ADDRESS
CHANGE OF USE FROM
6.
PHONE
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PHONE
ZIP
TO
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. g_MECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Fee
North 'South
Size of Parcel
Type Const.
East 'West
Occupancy
Valuation
Main Floor
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors I Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC IB! ORK
8. (L 4 c'�J
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATEI '
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 authority 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
DATE OF APPLICATION _'43 ° SIGNATURE OF APPLICANT 5d!'e
SPECIAL APPROVALS SPECIAL CONDITIO
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BlxJIdini>\T
, .e' A
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ >C
PERMIT NUMBER
—72,b0
04* *180.0
*18.006
A *000
925.92
09 -20 -83
z 6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I01 l ,fi ,.
09-2G-83
92'6.05
DATE ISSUED.. PERMIT NO.
*18.00 °J
TOTAL