1981, 08-27 Permit: 81A-8606 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
.23
LOT BLOCK
SUBDIVISION
OWNER
3. A. le'/.7
ADDRESS
4.
PHONE
Skik. et d'& 9.Zv-GZYS
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
E. /3//.5 01 3 d S`ud. c - L/ek
CONTRACTOR
4 r.Ai• 61,14/fy hi"-
ADDRESS
E. i01 /i c 1,4/4-;
DESIGNER
5. ADDRESS
ZIP
y.a /4,
Actual Set Backs in Feet
North 'South East 'West
PHONE
/'-t jai -„2/U!'
Size of Parcel Zone Classification
Std' a .u�.e L.%r
Type Const.
Occupancy
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
O NEW
O BLD.
O ALT.
❑ PLMB.
PHONE
ZIP
TO
❑ AD'N.
LI MECH.
O RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
Valuation
Main Floor
®'�
Area of Decks
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement 1 Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WORK
8. /vv,
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
4r' n y.0 e -
is
WATER
SEWER
Enum. Dist. I Location (Area)
Ownersh ip
Public ❑ Private 0
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
(/01- c1 /+rte SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B 'ding hnician
SPECIAL CONDITIONS:
ie'
PERMIT IS NONTRANSFERABLE
e -t
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
er-
/
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
i0, G'tJ
$ /5 CU
PERMIT NUMBER
u4* *14,00
* 1 4,00
* 1 4.006
A *0.00 8
86062
08-27-81
s 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-27-81 860.75 *1400x1
DATE ISSUED
PERMIT NO.