1981, 06-23 Permit: 81A-6256 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 AtDDRESS
l rr
LOT
BLOCK
3.
4.
OWNER
SUBDIVISION
1.1
ADD 12 ESS .
CONTRACT, O
I�- 1
PHONE
•
J>r
ZIP
AD ESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
P ONE
7.1975
PHONE
ZIP
TO
NEW ❑ ALT. ❑AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL
9.
SOURCE
OF
UTILITIES
❑ OTHER
GAS
ELECTRIC
WATE R
SEWER
LEGAL DESCRIPTION - SEE ATTACHED
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private 0
No. Rooms
Location (Area)
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions includeo
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 constructiop. SEE REVERSE SIDE FOR REQUIRED INSPECTIOINS
DATE OF APPLICATION
(4'
SIGNATURE OF APPLICANT ��.c •
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
j4) t5r-_737 . c),r/l.�,i
NL .Il i 50 N. 13,-rd)
r' (i")
•
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
$
PERMIT NUMBER
04* *1800
*1600
* 1 80025
A *0.00
62552
06-23-8+1
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
625.62 *18.0.0 ET -
PERMIT NO. TOTAL