1981, 04-13 Permit: 81A-3457 FurnacePLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
b SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7
A ) NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT B O K 15U13DIV1510N PARCEL NUMBER/S
NER
3 DDRESS'
.;Z
CdnTRACTOR
4. ADDRESS
L; t. a "!�; az,''
DESIGNER
5. ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
�t
North South
PHONE
Size of Parcel
Z ;,. _
"7
ZIP
Type Const.
Occupancy
..
PHONE
Valuation
ZIP I Main Floor I Upper Floors
zone Classitication
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area I Storage
04* *1800
*1JO U)
*18006
A *0 0 00
�45f�
04-13—.�1
6479.
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. k MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
D SCRIBE WO K Enum. Dist. Location (Area)
FEES COLLECTED
8.
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF Public ❑ Private ❑
9. UTILITIES
Single $ ,,
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 Building
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 Plumbing
DATE OF APPLICATION`" ���' SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
r
Utilities
Plans Examiner
S
ng/T�ecAnicia .I PERMIT IS NONTRANSFERABLE
0 et- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
TOTAL $ /F--0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
t
0 ��4v- l"r"741 3 4 W g
DATE ISSUED PERMIT NO.
*18.00a�
TOTAL
r
c
C
C
L
L