1981, 11-02 Permit: 81B-1380 FurnacePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
1.
2.
3
4.
JOB ADDRESS
LOT 1 (BLOCK ISUBDIVISIO
DRIVE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
CARL 12 OITROA1
ADDRESS ,
nein 21 17 FMAI VI DA A. VP
CONTRACTOR
POWERS. INCORPORATED
PHONE
ZIP
4920A
Actual Set Backs In Feet
North (South ]East (West
PHONE
535-7714
Size of Parcel 1 Zone Classification
ADDRESS
EaAt 6507 Mallon Avenue
ZIP
99206
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation 1 Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
0 NEW
❑ BLD.
O ALT. l AD N. 0 RPL. 0 MVE.
O PLMB. W MECH. 0 M.H. '0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of_ EX EMPTI ON
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8• Reptaee buitn.t out 4Uhnaee C
en)
9.
�WATER
WATER
VALUATION
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
Location (Area)
SEWER
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 hof construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
es
SEPA Check]
Bu
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
. FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Pehmt.t
Other (Specify)
6.00
0.00
TOTAL $ 16.00
PERMIT NUMBER
eiI3
04* *1500
* 1500
* 15006
A *000 g
1 37.92
1.1 -02-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
� .4
1'1 !i.O'2!1-1�81P11 '
DAT;.1 l�,r>
E ISSUED PERMIT NO.
1,3'8,02 *15.00 -
TOTAL