1981, 08-20 Permit: 81A-8362 Furnace, PipingPLAN 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 ADDRESSS,
LOT BLOCK
2.
Si e
SUBDIVISION
OWNER
1)0,-t V.—NW►Lt i�11
PHONE
424:0-1Kv ‘CE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
k404 S . WooIJ ...44L 3 NZOG
ZIP
Actual Set Backs In Feet
North (South East 'West
CONTRACTOR
4.
ottnte
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
TO
CI NEW 0 ALT. 0 AD N. 0 RPL 0 MVE.
❑ BLD. 0 PLMB. "MECH. 0 M.H. 0 POOL
0 OTHER
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation (Building Area in Sq. Ft.
Main Floor
Upper Floors 1 Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
VALUA+IONSOURCE GAS ELECTRIC WATER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu in chnician
SPECIAL CONDITIONS: (c)0—
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. CO
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
5i pc —$ 3GZ
04* *24.00
*24.00
*24,006
A *0.00 S
8361•g
08-20-81
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
836.2z *24002 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
FII F rnPv