1981, 10-02 Permit: 81A-184 Furnace, PipingSize of Parcel
PLAN 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
LOT BLOCK
OWNER
3. C�FLi'CiC
SUBDIVISION
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
•6131c,
ZI P
4.
CONTRACTOR
Ncxar(fu% r
ADDRESS
E T,.vt,
PHONE
E: r4jc�
DESIGNER
ADDRESS
CHANGE OF USE FROM
6. C> i
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
ZIP
eiu
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
E MVE.
❑ POOL
❑ OTHER
Actual Set Backs in Feet
North (South (East West
Type Const.
0 cell pa ncy
Valuation
Main Floor
DESCRIBE WORK
8. 110; PC,()
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
AC
SEWER
Upper Floors
Area of Decks
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Req'd.
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 regulatin constru tion or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE TJONS
DATE OF APPLICATION ��i { SIGNATURE OF APPLICANT ` -6° l
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B (ding chnician
SPECIAL CONDITIONS: ,s
"
FEES COLLECTED
Single $
Building
Plumbing
Mech. ��1
Plan Check
— SEPA
Mobile Home
Other (Specify)
TOTAL $ '1e( .oO
PERMIT NUMBER
Si14 ` •tU,4-
04* *19,00
* 19.00 N
* 1 9.006
A *0.00
1832
10-02-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE` �I 1
10�;`wl ����-181`
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
7
18,42 *'1.9,00Q.I-