1981, 11-13 Permit: 81B-1769 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 ADDRESS
1. GL}bO
LOT sr/I BLOCK
2.
3.
4.
SUBDIVISION
DWNEIj� ,tom r-
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/5
ADDR2/,, // �-y� �y� ,.
-&bZZ ✓`�\ CA/4x C'r
CONTRA T R
` ORADo7 &il-/<55
r-.1S6c161sciN
PHONE
Wseal
Actual Set Backs in Feet
North (South East iWest
PHONE
�7 - I9
17,7-0 7
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
VIEW 0 ALT. ,/
0,AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. iE MECH. 0 M.H. 0 POOL
Area of Decks
Finished Basement
Unfin. Basement
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
B.
DESrif
CRIBE I�1�(i2V I2- M 1 ! �YI'V� 1 ( EWER
VALUATION SOURCE GAS ELECT IC WATER
OF
9. UTILITIES
Enum. Dist.
Location (Area)
Ownership
Public 0 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 INSPENS
DATE OF APPLICATION / / ^ % 7 -*- / SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE -
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Technic' r
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing •
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *1-9.00
*19.00 V)
*19.006
A *000 0
1,7688
11-13-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•1.1 i-1 + tj i�.;
117491 *19.00a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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WHEN
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