1982, 07-19 Permit: 82A-6162 FurnaceALAN NUMBER. I APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOBAD RESS
`�9 �� LEGAL DESCRIPTION — SEE ATTACHED
W4
LO BLOCK ISUBDIVISION I PARCEL NUMBER/S
^ PERMIT NUMBER
DATE
VALUATION
9.
O NER
AS
ELECTRI
PHONE
ER
Single $
3.
on reverse side, and know the same to be true and correct. All provisions of laws and orningBuilding
type of work will be complied with whether specified herein or not. The granting of a pepreto
give authority to violate or cancel the provisions of any other state or local law regulatn o
ADDRESS
ZIP
Required Set Backs in Feet
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health /
North South
East West
CONTRACTOR
Fire Marshall Mobile Home
PHONE
Size of Parcel
Zone Classification
4.
TOTAL $ _k!—G'
Zone Clearance
WHEN MACHINE VALIDATED
AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
(�-�'`-+
per—_
I
❑Yes ❑No [:] Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
s.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE El NEW ALT.
1-1AD'N. El RPL.
ElMVE.
7,
OF
❑ OTHER
❑ BLD. 1-1PLMB.
ElMECH: E)M.H.
ElPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
8.
FEES COLLECTED
^ PERMIT NUMBER
DATE
VALUATION
9.
Source
ofF
Utilities
AS
ELECTRI
WATERLdoes
ER
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICinclj
on reverse side, and know the same to be true and correct. All provisions of laws and orningBuilding
type of work will be complied with whether specified herein or not. The granting of a pepreto
give authority to violate or cancel the provisions of any other state or local law regulatn o
Plumbing
performance of construction.
DATE 'Z '—� $L SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health /
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities p� Q}(7
TOTAL $ _k!—G'
Zone Clearance
WHEN MACHINE VALIDATED
P
SEPA Checklist THIS] C S RMIT.
`�Ur�.�
DATE ✓ r �ICAIAL,�
04* *1400
* 1 4.000
A *nC0 COD
61 6.1
07-19-82
z 6.479.
IS SPACE,
61625
*14.000.1-
❑
2