1981, 02-23 Permit: 81A-1727 Furnace, PipingPLAN NUMBER
(b}
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.
JOB ADDRESS
v Cr 1 pwpl5H
LOT BLOC SUBDIVISI
f
OWNER
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
3 F £) JV 1+ R I) /3 f- T ii c/ L/ p 9 s'
ZIP Actual Set Backs in Feet
? -6 6 North (South
CONTRACTOR ti PHONE Size of Parcel
PARCEL NUMBER/S
ADDRESS
4.
4 NI 117—
NR
i 'a v f— / 7 /N 6— a
ADDRESS T
ly
DESIGNER
5. ADDRESS
East 'West
I Zone Classification
Zip Type Const.
PHONE
CHANGE OF USE FROM
6.
TO
ZIP
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation 1 Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
} ALT.
❑ PLMB.
❑ AD'N.
MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DE RIBE WORK
-2 C1. --"a
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Enum. Dist. I Location (Area)
WATER
SEWER
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• construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION `�
_ SIGNATURE OF APPLICAN
PECIA' APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ng T ni 9n
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
h" 1
Plumbing j a c' c' �?
2 v O
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
(7c)
TOTAL $ I71.
PERMIT NUMBER
04* *18.00
* 18.00
* 18,006
A *0.00 8
172,68
02-23-81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02723-81
17 27 z *('8.0'0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DA PERMIT NO. TOTAL