1981, 04-20 Permit: 81A-3680 FurnacePLAN 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
JOB ADDRESS
I‘)1
LOT
2.
BLOCK
1Q
SUBDIVISI N
LEGAL DESCRIPTION - SEE ATTACHED
DIo3.
ADDRESS
k11( E
0126—Dari
71P
4.
5.
CONTR TOR r 14 11 r i -
ADDRESS
DESIGNER
7
PARCEL NUMBER/5
Actual Set Backs In Feet
North (South [East (West
Size of Parcel I Zone Classification
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
6.
CHANGE OF USE FROM
Ot
❑ NEW
❑ BLD.
TYPE
7. OF
WORK
TO
RALT. 0 AD'N. 0 RPL. 0 MVE.
,,��,,
0 OTHER
❑ PLMB. ( ,1<CH. ❑ M.H. 0 POOL
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
..SCRIBE WORK
f;14 -.CA_
()JO k-4.-112
VALUATI
9.j43-7.(�-
SOURCE G
OF
UTILITIES
ELECTRIC
WATER
SEWE
g1/0
Enum. Dist.
Location (Area)
wnershlp
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 INSPECTIOi,t /
DATE OF APPLICATION 4 SIGNATURE OF APPLICANT : 44
SPECIAL APPROVALS
P.AME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
IngTechnician
42-
SPECIAL CONDITIONS:
FOR GAS APPLIANCES
PIPE SIZES 1 rr }-112 r
PIPE LENGTHS 4or 4- 7'
BTUS B O, oco �i— 3S cco°
tyl
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 $ 24 6)e
PERMIT NUMBER
Si w -mo=o
04* *24,00
* 24.00 N
* 24.006
A *0.00
367.92
04-20-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,O 2(0'1'
DATE ISSUED
368.08 *240020 —
PERMIT NO. TOTAL