1981, 10-23 Permit: 81B-1048 FurnaceyL..1V IVVIVI6Cr< I APPLICATION/ PERMIT , IPES iNUMB I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
n / NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
U APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
�.
F -
LOT I BLOCK B I IO PARCEL NUMBER/S
2.
OWNER PHONE
3. 1� R—,/ n I . STA N (— `S' 1>3E 1
ADDRESS
ZIP
Actual Set Backs in Feet
E sib C�2rgN1T �O►tvT t�Z
9q�O�
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
of Decks
Finished Basement
Unfin. Basement
6. f`i(&-( O t L
TArea
TYPE
No. Baths
No. Stories
No. Rooms
No. of Dwelling
E(
11� NEW El ALT. 1-1 AD'N. 1:1 RPL. 1-1 MVE.
], OF 1-1 OTHER
WORK El BLD. 1:1PLMB. H/ MECH. ❑ M. H. El POOL
CERTIFICATE
Req'd.
i Recd.
Not Req'd
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
8. G Ars FuaV,JAc e i 71.E arm a-c�
I
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
I
Public ❑Private ❑
Single $
1 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
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performanm of constructio . SEE REYE IDE REQUIRED INSPECTIONS
Plumbing
ALIGRAT(1\j
r7.OD
DATE O U
ATRE OF APPLICANT
Mech.
SPECIAL APPROVA S
SPECIAL CONDITIONS:
NAME rIATF
Plan Check
Env. Health
Planning
Fire Marshall
Engineer
lities
ns Examiner
PA Checklist
ilding Technician PERMIT IS NONTRANSFERABLE
S` PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $
CCL* RIC.
* 1 7.00
n �
li rot U '.
1U4.7
1 0-2-7 1
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
YO�-�12I-B''l 10 48 51
DATE ISSUED PERMIT NO.
* I Z 0'0 a.�
TOTAL
0
C
C
k
7